A Clinical Trial Using Spy Elite System in Planning Tissue Advancement Flaps After Ventral Hernia Repair

Not Applicable

Completed

Conditions: Ventral Hernia

Registration Number: NCT01886963

Lead Sponsor: Wake Forest University Health Sciences

Brief Summary: The purpose of this project is to assess the efficacy of the Spy Elite System (LifeCell Corporation, Branchburg, NJ, USA) in planning tissue advancement flaps and reducing wound complications after complex ventral hernia repairs. Complex ventral hernia repairs are associated with a high rate of wound complications. To a large degree these complications are caused by creating tissue advancement flaps to close the abdomen, which can compromise the blood supply to the skin and subcutaneous tissues. The current standard of care for assessment of blood perfusion to the flaps is a surgeon's clinical judgment. It is, however, often inaccurate. The Spy Elite System was developed to address this problem. The Spy Elite System is a device that enables surgeons to visualize and evaluate tissue perfusion in real time. It can help the surgeon to identify optimal flap design and reduce the risk of postoperative wound complications related to tissue ischemia. The primary goal of this study is to evaluate the efficacy of Spy Elite System to aid a surgeon in creating tissue flaps with adequate blood supply through a prospective, randomized clinical trial. The Spy Elite System has been used successfully for assessing the viability of mastectomy flaps in breast surgery and has been shown to be extremely sensitive in predicting mastectomy flap necrosis. However, no clinical trial has been conducted in order to evaluate the efficacy of the Spy Elite System for assessing the viability of abdominal subcutaneous flaps in complex ventral hernia repairs.

Detailed Description: More than 90,000 ventral hernia repairs are performed in the US annually. Large ventral hernias often require a complex abdominal wall reconstruction including creating tissue advancement flaps. Complex abdominal wall reconstructions are associated with up to 20% rate of wound complications including skin flap necrosis and wound breakdowns. Prevention of skin necrosis and ischemia would significantly reduce the morbidity associated with these procedures.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 115

Inclusion Criteria

Patients with ventral hernia that will require tissue advancement flaps at time of hernia repair
Age ≥ 18 years
Signed informed consent

Exclusion Criteria

ASA score IV or above
Age < 18 years
Patients with iodine allergy
Patients with current wound or mesh infection
Pregnant patients
Patients with End Stage Renal Disease

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Number of Participants With Wound Complications	12 Weeks	breakdown, necrosis, erythema, infection, or dehiscence with location specified

Secondary Outcome Measures

Name	Time	Method

Trial Locations

Locations (1): Atrium Health - Carolinas Medical Center
🇺🇸
Charlotte, North Carolina, United States
Atrium Health - Carolinas Medical Center
🇺🇸Charlotte, North Carolina, United States