- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT07676370
PROV-MESH: Prophylactic Ovarian Cancer MESH (PROV-MESH)
A Multicenter Randomized Clinical Trial Comparing Prophylactic Mesh Placement Versus Primary Closure, With or Without Negative Pressure Wound Therapy, in Patients Undergoing Primary or Interval Cytoreductive Surgery for Ovarian Cancer
Incisional hernia is a common complication after midline laparotomy and may significantly impact quality of life, morbidity, and healthcare costs. Patients undergoing cytoreductive surgery for ovarian cancer are considered at increased risk due to extensive surgical procedures, nutritional status, and exposure to systemic treatments.
This prospective randomized clinical trial aims to evaluate whether prophylactic mesh placement during abdominal wall closure reduces the incidence of incisional hernia compared with conventional fascial closure in women undergoing cytoreductive surgery for ovarian cancer through a midline laparotomy. To control for the potential effect of negative pressure wound therapy (NPWT) on surgical site infection, participants will also be randomized to receive NPWT or standard wound dressing, resulting in four treatment arms.
Studieöversikt
Status
Betingelser
Studietyp
Inskrivning (Beräknad)
Fas
- Inte tillämpbar
Kontakter och platser
Studiekontakt
- Namn: Jose Luis Sánchez Iglesias, MD PhD
- Telefonnummer: 3217 +34 932746000
- E-post: jlsanig@yahoo.es
Studieorter
-
-
Barcelona
-
Barcelona, Barcelona, Spanien, 08035
- Rekrytering
- Hospital Universitario Vall d'Hebron
-
Kontakt:
- Jose Luis Sánchez Iglesias, MD PhD
- Telefonnummer: 3217 +34 932746000
- E-post: jlsanig@yahoo.es
-
-
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
- Vuxen
- Äldre vuxen
Tar emot friska volontärer
Beskrivning
Inclusion Criteria:
- Female patients diagnosed with ovarian carcinoma.
- Undergoing primary cytoreductive surgery, interval cytoreductive surgery, or delayed cytoreductive surgery after six cycles of chemotherapy.
- Surgical procedure performed through a midline laparotomy.
- Ability and willingness to provide written informed consent.
Exclusion Criteria:
- Surgery for recurrent ovarian cancer (secondary, tertiary, or subsequent cytoreductions).
- Minimally invasive surgical approach.
- Planned secondary cytoreductive surgery during the 24-month follow-up period.
- Inability or unwillingness to comply with follow-up requirements.
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Förebyggande
- Tilldelning: Randomiserad
- Interventionsmodell: Faktoriell uppgift
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Experimentell: Prophylactic Mesh + Negative Pressure Wound Therapy
Participants will undergo standard fascial closure reinforced with a prophylactic supra-aponeurotic non-absorbable mesh and postoperative negative pressure wound therapy using a PICO dressing for 7 days.
|
Placement of a non-absorbable polypropylene or polyester mesh in a supra-aponeurotic position at the time of abdominal wall closure following cytoreductive surgery.
Application of a PICO negative pressure dressing after skin closure, maintained for 7 days postoperatively.
|
|
Experimentell: Prophylactic Mesh without Negative Pressure Wound Therapy
Participants will undergo standard fascial closure reinforced with a prophylactic supra-aponeurotic non-absorbable mesh and standard postoperative wound dressing.
|
Placement of a non-absorbable polypropylene or polyester mesh in a supra-aponeurotic position at the time of abdominal wall closure following cytoreductive surgery.
|
|
Aktiv komparator: Conventional Closure + Negative Pressure Wound Therapy
Participants will undergo standard fascial closure without mesh reinforcement and postoperative negative pressure wound therapy using a PICO dressing for 7 days.
|
Application of a PICO negative pressure dressing after skin closure, maintained for 7 days postoperatively.
Continuous closure of the abdominal fascia using slowly absorbable monofilament suture (PDS 2-0), single-layer closure without peritoneal closure, maintaining a suture-to-wound length ratio greater than 4:1 and employing the small-bites technique.
|
|
Experimentell: Conventional Closure without Negative Pressure Wound Therapy
Participants will undergo standard fascial closure without mesh reinforcement and standard postoperative wound dressing.
|
Continuous closure of the abdominal fascia using slowly absorbable monofilament suture (PDS 2-0), single-layer closure without peritoneal closure, maintaining a suture-to-wound length ratio greater than 4:1 and employing the small-bites technique.
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Incidence of Incisional Hernia
Tidsram: 24 months after surgery
|
Presence of an abdominal wall incisional hernia confirmed by computed tomography (CT scan) or by imaging performed after clinical suspicion during follow-up.
|
24 months after surgery
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Incidence of Surgical Site Infection
Tidsram: Within 30 days after surgery
|
Surgical site infection according to CDC criteria.
|
Within 30 days after surgery
|
|
Incidence of Incisional Hernia at Intermediate Time Points
Tidsram: 3, 6, and 12 months after surgery
|
Radiologically confirmed incisional hernia detected during routine follow-up imaging.
|
3, 6, and 12 months after surgery
|
|
Risk Factors Associated With Incisional Hernia Development
Tidsram: Up to 24 months
|
Identification of demographic, clinical, oncological, and surgical variables associated with incisional hernia occurrence.
|
Up to 24 months
|
Samarbetspartners och utredare
Sponsor
Studieavstämningsdatum
Studera stora datum
Studiestart (Faktisk)
Primärt slutförande (Beräknad)
Avslutad studie (Beräknad)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Ytterligare relevanta MeSH-villkor
- Urogenitala sjukdomar
- Genitala sjukdomar
- Sjukdomar i det endokrina systemet
- Urogenitala neoplasmer
- Neoplasmer efter plats
- Neoplasmer
- Kvinnliga urogenitala sjukdomar
- Kvinnliga urogenitala sjukdomar och graviditetskomplikationer
- Genitala sjukdomar, kvinnor
- Neoplasmer i endokrina körtel
- Ovariella sjukdomar
- Adnexala sjukdomar
- Genitala neoplasmer, hona
- Gonadal sjukdomar
- Ovariella neoplasmer
- Terapeutik
- Kirurgiska ingrepp, operativ
- Dränering
- Sårstängningstekniker
- Sårterapi med negativt tryck
Andra studie-ID-nummer
- PI-24-055
Plan för individuella deltagardata (IPD)
Planerar du att dela individuella deltagardata (IPD)?
IPD-delning som stöder informationstyp
- STUDY_PROTOCOL
- SAV
- ICF
- CSR
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