Can a Low Cost, Simple Needle-Aspirated Compression Dressing Reduce Surgical Site Infection Rates of Primarily Closed Ileostomy and Colostomy Reversal Wounds?
试验速览
- 阶段
- 3 期
- 入组人数
- 122
- 试验地点
- 2
- 主要终点
- Surgical Site Infection
研究概览
简要总结
Negative pressure wound dressings have been studied and shown to have applications in decreasing rates of surgical wound infections. This study studies the effect of a low cost needle-aspirated negative pressure compression dressing on rates of wound infection at prior ostomy site in patients undergoing ostomy reversal surgery.
详细描述
Negative Pressure Wound Therapy (NPWT) will be studied in colorectal surgery patients undergoing ostomy reversal surgery. The immediate goal is to compare primary wound closure against primary closure with needle-aspirated compression dressing, and determine if risk of potential ostomy site wound infections is decreased. The investigators would also like to evaluate if this compression dressing can increase prevalence of complete wound closure by 12 weeks (last planned clinic visit). NPWT using a continuous suction device was shown to decrease surgical site infection (SSI) at ostomy reversal sites undergoing primary closure. There is a lack of published literature studying NPWT dressings without an associated suction device. The investigators will be using a low-cost simple needle-aspirated suction technique to provide negative pressure under a tegaderm/gauze dressing, at the time of placement. Patients will be consented and randomized into a negative pressure group, or a control group consisting of the same dressing under normal pressure. All adult patients undergoing ostomy reversal surgery who consent to the study will be included. Exclusion criteria include prior recurrent skin infections, prior stoma-site infection, or large parastomal hernia. Patients in the negative pressure group will have the pressure under the dressing measured immediately prior to removal on post-operative day 2.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •at least 18 years of age
- •presence of a loop or end colostomy or ileostomy
- •consenting to study and to ostomy reversal
排除标准
- •altered mental status or patients unable to sign the informed consent form
- •vulnerable patient populations such as prison and ward patients
- •patients who are discovered before or during surgery as unable to undergo placement of compression dressing will be excluded.
- •Patients with visible protrusion/evidence of large parastomal hernia
- •history of recurrent skin & soft tissue infections
- •history of previous stoma site infection or complications
- •patients with extensive comorbidities (such as cancer involving stoma site, uncontrolled diabetes, etc), Crohn's patients and abdominal wall fistula patients
- •patients in who primary closure of wound is deemed inappropriate by the operating surgeon, requiring a different method of stoma site wound management
研究组 & 干预措施
Control
primary closure with gauze and adhesive/occlusive dressing
干预措施: Control (Procedure)
Negative Pressure
primary closure with gauze and adhesive/occlusive dressing under negative pressure
干预措施: Needle-Aspirated Negative Pressure Dressing (Procedure)
结局指标
主要结局
Surgical Site Infection
时间窗: 30 days post procedure
Surgical Site Infection
次要结局
- Rate of Wound Closure(3 weeks post procedure and 12 weeks post procedure)
研究者
Sang Won Lee
Professor of Clinical Surgery, Chief, Division of Colorectal Surgery
University of Southern California
