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临床试验/NCT07607366
NCT07607366招募中不适用

Is Negative Pressure Wound Therapy Associated With a Decreased Risk of Postoperative Seroma in Breast Cancer Patients Who Have Undergone Mastectomy?

Dalarna County Council, Sweden1 个研究点 分布在 1 个国家目标入组 76 人开始时间: 2025年3月1日最近更新:
干预措施

试验速览

阶段
不适用
状态
招募中
发起方
入组人数
76
试验地点
1
主要终点
Number of participants with postoperative seroma

研究概览

简要总结

Participant information sheet:

Mastectomy is a surgical method used to treat breast cancer. A mastectomy involves the removal of the entire breast. A common postoperative complication after a mastectomy is seroma, i.e. an abnormal accumulation of serous fluid in the wound cavity. At present, at Falun regional hospital, conventional dressings are used on the wound after the operation as well as an active drainage that is left in place for a couple of days. There is research that suggests that negative pressure dressings can promote wound healing and reduce the formation of seroma. The purpose of this study is to investigate whether negative pressure dressings reduce the risk of postoperative seroma compared to regular dressings. The investigators will also look at whether it reduces the risk of other postoperative complications such as infection, bleeding and wound healing problems. The investigators are asking all patients who will undergo a mastectomy in 2025 if they want to participate in the study. The Director of Research, Education and Innovation is the authorized representative of the research principal (which is the legal entity Region Dalarna). Research principal means the organization responsible for the project. The research is approved by the Ethics Review Authority, the registry number for the trial at the Ethics Review Authority is 2025-00006-01.

Participating in the study means that on the day of surgery participants will be randomized between two groups. One group will receive conventional wound dressings, and the other group will receive PICO negative pressure dressings. The negative pressure dressing is connected to a small canister that is worn for 7 days. Just like today, there will be a return visit to the nurse in the surgery ward after a day to check and possibly remove the active drain. There will also be a return visit to the doctor after 2-3 weeks for results of the tissue analysis and information about further treatment. The additional visit for participants in the study is a return visit to the nurse after 7 days to remove the PICO negative pressure dressing (if the participant belongs to that group). A return visit to the nurse is also planned after 6 months as a follow-up. If participants have any questions or problems, participants can contact the contact nurse. The PICO negative pressure dressing is connected to a cord with a small canister that must be carried with the participant. The canister fits in a pocket. The canister is on 24 hours a day and emits a light vibration sound. The project will collect and register information about participants. Information about participant medical history, measurements, medications, type of surgical procedure, number of return visits after surgery and postoperative complications will be collected from participants medical record to analyze the results. The data will be pseudonymized and entered into a password-protected Excel document for analysis. The code key is stored in a lock-protected Excel file. The code key is processed so that unauthorized persons cannot access it. Participants answers and results will be processed so that unauthorized persons cannot access them. The code key and research data are stored for 10 years in accordance with research ethics because it should be possible to go back to the research data and re-analyze if question marks arise about our analysis methods. The data protection officer of Region Dalarna is responsible for parti personal data. According to the EU Data Protection Regulation, participants have the right to access the data that is handled in the project free of charge, and to have any errors corrected if necessary. Participants can also request that data about them be deleted and that the processing of participants personal data be restricted. However, the right to deletion and restriction of processing of personal data does not apply when the data is necessary for the current research. If participants would like to access the data, please contact the principal investigator (Rebecca Paul, rebecca.paul@regiondalarna.se, 023 490760). The data protection officer can be reached at dataskyddsombud@regiondalarna.se, Tel: 023-490000. If participants are dissatisfied with how their personal data is processed, they have the right to file a complaint with the Swedish Data Protection Authority, which is the supervisory authority. Participants can access their individual data in their medical record. The results of the entire study will be reported internally at Kirurgkliniken Falun regional hospital and are intended to be published in a scientific journal. Unforeseen findings will be handled through follow-up and, if necessary, treatment. Patient insurance valid through the research principal. Participants will not receive compensation as the study is part of a planned procedure. Participation is voluntary.

详细描述

Is negative pressure wound therapy associated with a decreased risk of postoperative seroma in breast cancer patients who have undergone mastectomy?

Introduction Breast cancer is the most common cancer in women in Sweden as well as globally. In 2022, there were 2,3 million women diagnosed with breast cancer and 670 000 deaths globally. More than every tenth woman in Sweden will suffer from breast cancer during their lifetime. Since the 1970s the 10 year survival rate in Sweden has increased from around 54% to 88% and the 5 year survival rate has increased from around 69% to 93%.

There are two main types of surgical treatment for breast cancer, breast-conserving surgery and mastectomy. The number of mastectomies have gradually decreased because of decreased tumor size at diagnosis and an increased use of oncoplastic surgery and preoperative treatment. However, it still has an important role with indications like: inflammatory tumor, T4-tumor after preoperative treatment, large tumors that progress during preoperative treatment, local recurrence after previous partial mastectomy with radiotherapy, multicentric tumors, persisting positive margins after extended excision after partial mastectomy or contraindications for postoperative radiotherapy.

Wound complications after mastectomy such as surgical site infections (SSI), seromas, wound dehiscence, wound necrosis and hematoma are a frequently occurring problem. The complications are a major cause of morbidity for patients and a significant cost burden for healthcare providers. Surgical site complications in breast cancer patients can also delay the initiation of adjuvant treatment and may negatively impact both recurrence risk and overall survival.

There is research showing that Negative Pressure Wound Therapy (NPWT) reduces the risk for SSI with up to 33% compared to standard care, over a range of surgical specialties. It is also a promising technique for preventing and managing wound complications in high-risk closed incisions. NPWT is thought to reduce bacterial contamination, exudate and edema, promote lymphatic and local blood flow, and stimulate tissue granulation. No significant difference has been observed between -80mmHg and -125mmHg devices.

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
Female
接受健康志愿者

入选标准

  • Breast cancer patients undergoing mastectomy
  • Age >= 18 years

排除标准

  • Direct reconstruction with implants
  • The use of Harmonic Johnson and Johnson instrument during surgery

研究组 & 干预措施

Negative pressure wound therapy

Experimental

PICO negative pressure wound therapy

干预措施: PICO negative pressure wound therapy by Smith and Nephew (Device)

Control group

No Intervention

Conventional dressings

结局指标

主要结局

Number of participants with postoperative seroma

时间窗: 6 months

Seroma was defined as clinically verified exudate in the wound cavity. The amount of seroma aspirated was measured in millilitres and the number of aspirations per participant was recorded.

次要结局

未报告次要终点

研究者

发起方
Dalarna County Council, Sweden
申办方类型
Other
责任方
Principal Investigator
主要研究者

Rebecca Paul

Medical Doctor

Dalarna County Council, Sweden

研究点 (1)

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