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Trial registered on ANZCTR
Registration number
ACTRN12616000890437p
Ethics application status
Submitted, not yet approved
Date submitted
29/06/2016
Date registered
6/07/2016
Date last updated
6/07/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
A trial on same day discharge after drainage of abscesses
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Scientific title
A Randomised Clinical Trial on Same Day Discharge post Drainage of Abscess
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Secondary ID [1]
289572
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nil
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Universal Trial Number (UTN)
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Trial acronym
SDDDA
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
abscess
299301
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Condition category
Condition code
Infection
299297
299297
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0
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Other infectious diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intervention arm: Same day discharge following Drainage of Abscess
*Pre-operative: Same as the standardised discharge patients. In addition, the Acute Care at Home service will be notified for discharge planning. The Duty Anaesthetist and theatre coordinator will be notified that the patient will be for same day discharge. The procedure will be scheduled with priority for same day discharge.
*Intra-operative: Same as the standardised discharge patients.
*Post-operative: The patient will be discharged home from recovery, with an admission to the Acute Care at Home service. The admission will be completed on the next day and community wound care will be arranged during the admission.
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Intervention code [1]
295174
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Treatment: Other
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Comparator / control treatment
Intervention: Same day discharge
Control: admit overnight as in-patient (current standard of care)
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Control group
Active
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Outcomes
Primary outcome [1]
298789
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Outcome: re-admission
Re-admission is defined by
*Patient return to hospital emergency to receive further care related to the abscess or the drainage procedure.
This outcome is assessed by the patient returned to hospital, in which the team responsible to the trial will be contacted since it is the treating team. Patients will also be phoned at 30 days post-discharge to assess whether they have presented to other hospitals.
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Assessment method [1]
298789
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Timepoint [1]
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30 days post abscess drainage procedure
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Secondary outcome [1]
325205
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complication encountered according to the scale of Clavien-Dindo classification of surgical complications
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Assessment method [1]
325205
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Timepoint [1]
325205
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30 days post abscess drainage procedure
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Secondary outcome [2]
325235
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length of stay - total length of stay in hospital. Data collected via hospital system (eRecord, ERIC)
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Assessment method [2]
325235
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Timepoint [2]
325235
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will collect the LOS data at 30 days post abscess drainage procedure
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Secondary outcome [3]
325236
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theatre start time, Data collected via hospital system (ORMIS)
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Assessment method [3]
325236
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Timepoint [3]
325236
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will collect the LOS data at 30 days post abscess drainage procedure
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Eligibility
Key inclusion criteria
Adult population with an abscess (perianal, pilonidal and/or cutaneous) and presented to Logan Hospital emergency
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients will be excluded if they:
Were determined by the treating surgeon that they have systemic inflammatory response and not suitable for early discharge.
Have other reasons that patients need to remain as in-patients, determined during the admission process.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
treatment team will be notify during request for admission. the patient will be allocated to an arm (early discharge or standard discharge) and therefore the allocation process is blinded to the treatment team.
The allocation process:
allocation involved contacting the holder of the allocation schedule who is the in-charge surgeon not in the emergency department. Central computerised randomisation will be performed by the surgeon and notify the admission staff (registrar).
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
centralised computer generated randomisation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
non-inferior study.
intervention (n=50) and control group (n=50) with 5% drop out
If there is truly no difference between the standard and experimental treatment, then 96 patients are required to be 90% sure that the upper limit of a one-sided 95% confidence interval (or equivalently a 90% two-sided confidence interval) will exclude a difference in favour of the standard group of more than 6%
alpha 5%
1-beta 90%
percentage of complication in intervention group 1%
percentage of complication in control group 1%
sample size 45 in each group
sample size 50 in each group if 5% drop out
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
11/07/2016
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Actual
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Date of last participant enrolment
Anticipated
31/10/2016
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Actual
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Date of last data collection
Anticipated
5/12/2016
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Actual
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
6043
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Logan Hospital - Meadowbrook
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Recruitment postcode(s) [1]
13490
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4131 - Meadowbrook
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Funding & Sponsors
Funding source category [1]
293946
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Hospital
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Name [1]
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Logan Hospital
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Address [1]
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Armstrong Rd, Meadowbrook QLD 4131
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Country [1]
293946
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Australia
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Primary sponsor type
Hospital
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Name
Logan Hospital
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Address
Armstrong Rd, Meadowbrook QLD 4131
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Country
Australia
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Secondary sponsor category [1]
292768
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None
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Name [1]
292768
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Address [1]
292768
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Country [1]
292768
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
295369
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Logan Ethics advisory group
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Ethics committee address [1]
295369
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Logan Hospital, Armstrong Rd, Meadowbrook QLD 4131
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Ethics committee country [1]
295369
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Australia
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Date submitted for ethics approval [1]
295369
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14/06/2016
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Approval date [1]
295369
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Ethics approval number [1]
295369
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Summary
Brief summary
Post-operative care usually includes an overnight hospital stay, to ensure adequate analgesia, satisfactory haemostasis. Patients with an abscess drained will stay until the next morning with examination of the wound and the removal of the haemostatic pack. It is the fact that there is a logistic reason to keep the patients postoperatively. Baker et al illustrated their similar experience in NZ about theatre access (Baker 2009). Drainage of an abscess received a relatively low priority since it can be done by more junior staff after hours. Patients tend to have prolonged stays if access to theatre is an issue. There is currently no evidence to keep post abscess drainage patient in the hospital otherwise (Akkapulu 2014). It is time to encourage a better use of hospital resources in managing this common condition. The proposed change is to perform the drainage procedure early at the start of the ASU theatre list with minimal anaesthesia. There is evidence that for lower torso procedures, a smaller dose of spinal anaesthesia enables early ambulatory and shorter recovery period from anaesthesia. The patient is then referred to Acute Care at Home service for observation and to be discharged on the next day. Adequate analgesia and antibiotics will be dispensed prior the patient is being discharge from recovery. The ASU team can be contacted if concerns are raised by the Acute Care at Home service. The patient is then referred to Community Wound services for post-operative wound care. The complication and re-admission rate post drainage are very low (<1%) in the current management of abscesses, according to the ASU internal audit. It is important to ensure this low complication and re-admission rate continue in the new management model. The purpose of this trial is to demonstrate the safety of this new management.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Mr Yiu Ming Ho
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Address
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Logan Hospital, Armstrong Rd, Meadowbrook QLD 4131
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Country
67030
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Australia
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Phone
67030
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+61732996300
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Fax
67030
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Email
67030
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[email protected]
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Contact person for public queries
Name
67031
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Yiu Ming Ho
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Address
67031
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Logan Hospital, Armstrong Rd, Meadowbrook QLD 4131
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Country
67031
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Australia
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Phone
67031
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+61732996300
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Fax
67031
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Email
67031
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[email protected]
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Contact person for scientific queries
Name
67032
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Yiu Ming Ho
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Address
67032
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Logan Hospital, Armstrong Rd, Meadowbrook QLD 4131
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Country
67032
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Australia
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Phone
67032
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+61732996300
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Fax
67032
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Email
67032
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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