Investigating the Feasibility and Outcomes of Patient Self-Drain Removal After Ventral Hernia Repair
- Conditions
- Ventral Hernia
- Interventions
- Other: Self-drain removal
- Registration Number
- NCT06237855
- Lead Sponsor
- Wake Forest University Health Sciences
- Brief Summary
The goal of this randomized controlled trial is to teach patients to safely and effectively self-remove drains at home in adults (aged 18 and older) following a ventral hernia repair (VHR). Researchers will compare the group of subjects self-removing the drain at home to a control group of standard of care drain removal during a clinic visit by a provider to see if subjects are able to safely self-remove the drain at home.
- Detailed Description
Annually, in the United States, it is estimated that 500,000 ventral hernia repairs (VHRs) are performed with a cost in excess of $3.2 billion. Drains are frequently used in an effort to prevent seroma formation. Seromas are defined as a buildup of bodily fluid in a potential space post-surgery, usually at the surgical site. Rate of seroma has been estimated to be between 9-11% following abdominal wall reconstruction (AWR). The timing of the removal is usually after discharge but before patient's scheduled postoperative visit, thus most patients must call and speak to a health provider and come in for an additional clinic visit specifically for drain removal. The goal of this study is to teach patients to safely and effectively self-remove drains at home. This will allow patients to forgo the cost associated with commuting to the clinic, the clinic cost associated with nursing time and scheduling, the clinic visit, physician or nurse time to remove the drain and possibly lost wages for the patient from time off work. It is important to note that self-drain removal will not compromise or deviate from typical patient follow up. Instead, this will eliminate an extra patient visit when inevitably the timing of drain removal does not align with the typical follow-up period. Additionally, this will allow providers to see additional patient consultations or perform other duties, as they will not have the time constraints associated with in-office drain removal. This study will show that patient self-drain removal benefits the patients, the providers, and healthcare system without compromising patient safety, satisfaction, and postoperative care.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 100
- Aged ≥18 years.
- Undergoing elective ventral hernia repair (VHR).
- Sub-cutaneous drain placement.
- Anticipated Centers for Disease Control and Preventions (CDC) 1&2 wound class.
- Patients who do not have access to the online training video.
- The surgeon does not believe the patient can self-remove the drain.
- Planned concomitant procedures.
- Current mesh infection.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Self-drain removal training Self-drain removal Subjects will remove drain at home Training will consist of a detailed online video of a provider instructing how to remove the drain and practicing on a model created specifically to mimic the following actions during drain self-removal: * Tension required to remove the drain * Placing and taping gauze after suture and drain removal
- Primary Outcome Measures
Name Time Method Success rate of patients self-removing drains 2 weeks post-operatively Percentage of patients that are able to safely self-remove drain at home.
- Secondary Outcome Measures
Name Time Method Post-drain removal satisfaction survey scores 30-days post-operatively Score on satisfaction survey following self-drain removal (intervention group only). Survey is on a 5-point Likert scale survey with 1 representing "strongly disagree" and 5 representing "strongly agree". Higher scores indicate greater satisfaction with at home self-drain removal.
Wound complication rate 30-days post-operatively. Comparison of the wound complication rate between the control and intervention groups. Wound complications will be defined as wound breakdown, wound cellulitis, hematoma, wound infection, and seroma requiring intervention. Each wound complication will be reported individually and as an aggregate wound complication overall rate.
Difference In Subject Costs 30-days post-operatively Difference in cost associated with reduction in clinic visits.
Difference in Subject Amount of Time 30-days post-operatively Difference in time associated with reduction in clinic visits and travel
Change in drain removal training survey scores from pre to post training Hour 1 Change in drain removal training survey scores from pre to post training. The same survey is given pre and post is training and is on a 5-point Likert scale survey with 1 representing "strongly disagree" and 5 representing "strongly agree". Higher scores indicate more confidence in the self-drain removing process.
Trial Locations
- Locations (1)
Carolinas Laparoscopic & Advanced Surgery Program
🇺🇸Charlotte, North Carolina, United States