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Trial registered on ANZCTR
Registration number
ACTRN12619000213145
Ethics application status
Approved
Date submitted
1/02/2019
Date registered
14/02/2019
Date last updated
4/02/2020
Date data sharing statement initially provided
14/02/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Prophylactic negative pressure wound therapy for reduction of surgical site infection in high-risk women undergoing open abdominal surgery: A quality improvement project
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Scientific title
Prophylactic negative pressure wound therapy for reduction of surgical site infection in high-risk women undergoing open abdominal surgery: A quality improvement project
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Secondary ID [1]
297271
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None
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Universal Trial Number (UTN)
U1111-1220-0307
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Surgical wound infection
311344
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Condition category
Condition code
Surgery
309981
309981
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0
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Surgical techniques
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Infection
310004
310004
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0
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Studies of infection and infectious agents
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Prophylactic use of the Smith & Nephew PICO negative pressure wound therapy system following open obstetric and gynaecological abdominal surgery in patients deemed high risk for developing surgical wound infection by the following criteria:
- Body mass index greater than or equal to 40 or
- Body mass index less than 40 plus two or more of the following risk factors: Diabetes, Steroids or Anticoagulants in the last 48 hours, Autoimmune disorders, Blood or haematological disorders, Immunosuppressant medication, Hypertensive disorders, Multiple laparotomies greater than or equal to 3, Previous wound infections, Pre-existing skin problems, Premature Rupture of Membranes, Preterm Premature Rupture of Membranes with Chorioamnionitis, Suspected or confirmed Chorioamnionitis, Prolonged labour with rupture of membranes and fetal scalp electrode.
Medical records of patients readmitted to hospital with surgical wound infection within 30 days of primary open obstetric and gynaecological abdominal surgery will be reviewed retrospectively from 1 January 2018 to 31 August 2019, excluding a washout period from 1 September 2018 to 31 December 2018 during which the Smith & Nephew PICO negative pressure wound therapy system was introduced. i.e. data from 1 Jan 2019 to 31 Aug 2019 is the exposure of interest and will be compared to data from the previous period from 1 Jan 2018 - 31 Aug 2018 before negative pressure wound therapy was in use.
The total population analysed will consist of approximately 2900 women, but only a high risk (approximately 20%) subset should receive the Smith & Nephew PICO negative pressure wound therapy system. The PICO dressing will be placed by the surgeon at the conclusion of the abdominal component of each operation.
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Intervention code [1]
313627
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Not applicable
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Comparator / control treatment
Patients readmitted to hospital with surgical wound infection within 30 days of primary open obstetric and gynaecological abdominal surgery performed 1 Jan 2018 to 31 Aug 2018 (prior to implementation of use of the Smith & Nephew PICO negative pressure wound therapy system in high risk individuals instead of standard OpSite wound dressings).
Data will be obtained from written and electronic clinical records obtained from Counties Manukau Health.
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Control group
Historical
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Outcomes
Primary outcome [1]
318896
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Hospital readmission with surgical site infection (SSI) as assessed by data linkage to medical records. SSI is defined per the internationally accepted modified CDC definitions of nosocomial surgical site infections.
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Assessment method [1]
318896
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Timepoint [1]
318896
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Within 30 days of primary surgery.
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Secondary outcome [1]
366361
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Return to the operating theatre as assessed by data linkage to medical records.
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Assessment method [1]
366361
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Timepoint [1]
366361
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Within 30 days of primary surgery.
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Secondary outcome [2]
366362
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Minimally invasive radiological interventions as assessed by data linkage to medical records.
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Assessment method [2]
366362
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Timepoint [2]
366362
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Within 30 days of primary surgery.
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Secondary outcome [3]
366363
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Treatment with antibiotics as assessed by data linkage to medical records.
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Assessment method [3]
366363
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Timepoint [3]
366363
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Within 30 days of primary surgery.
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Eligibility
Key inclusion criteria
All women undergoing open abdominal surgery where the responsible clinician is an obstetrician or gynaecologist at Counties Manukau Health (CMH) from 1 January 2018 to 31 August 2019, excluding a washout period from 1 September 2018 to 31 December 2018.
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Minimum age
5
Years
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Women whose primary surgery was performed outside Women’s Health CMH are excluded.
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Both
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Statistical methods / analysis
Consecutive block samples by month will be used to produce a run chart, to determine if a reduction in hospital readmissions with surgical site infection can be identified following introduction of the Smith & Nephew PICO negative pressure wound therapy system.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/03/2019
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Actual
1/03/2019
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Date of last participant enrolment
Anticipated
31/08/2019
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Actual
31/08/2019
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Date of last data collection
Anticipated
30/09/2019
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Actual
31/10/2019
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Sample size
Target
2900
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Accrual to date
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Final
3056
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Recruitment outside Australia
Country [1]
21241
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New Zealand
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State/province [1]
21241
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Funding & Sponsors
Funding source category [1]
301831
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Government body
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Name [1]
301831
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Counties Manukau Health
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Address [1]
301831
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Middlemore Hospital
Private Bag 93311
Otahuhu
Auckland 1640
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Country [1]
301831
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New Zealand
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Primary sponsor type
Government body
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Name
Counties Manukau Health
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Address
Middlemore Hospital
Private Bag 93311
Otahuhu
Auckland 1640
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Country
New Zealand
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Secondary sponsor category [1]
301576
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None
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Name [1]
301576
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Address [1]
301576
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Country [1]
301576
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
302533
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Health and Disability Ethics Committees
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Ethics committee address [1]
302533
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133 Molesworth Street Thorndon Wellington 6011
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Ethics committee country [1]
302533
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New Zealand
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Date submitted for ethics approval [1]
302533
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Approval date [1]
302533
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31/01/2019
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Ethics approval number [1]
302533
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18/CEN/277
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Summary
Brief summary
Background: Surgical site infection is a major reason for readmission to hospital. The evidence for prophylactic negative pressure wound therapy (suction wound dressing), for reducing wound complications, is conflicting. However, it seems likely that a benefit may be seen in appropriately selected, high risk patients. Aim: To evaluate if surgical site infections requiring readmission, are reduced following introduction of prophylactic negative pressure wound therapy for high risk patients. Methods: Medical records will be reviewed retrospectively prior to, and following, implementation of a clinical guideline promoting selective use of the Smith & Nephew PICO negative pressure wound therapy system. Population: All women undergoing open abdominal surgery where the responsible clinician is an obstetrician or gynaecologist at Counties Manukau Health from 1 January 2018 to 31 August 2019, excluding a washout period from 1 September 2018 to 31 December 2018 during which the Smith & Nephew PICO negative pressure wound therapy system was introduced.
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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
90550
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Dr Sam Holford
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Address
90550
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Middlemore Hospital
Private Bag 93311
Otahuhu
Auckland 1640
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Country
90550
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New Zealand
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Phone
90550
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+64 21 673 189
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Fax
90550
0
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Email
90550
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[email protected]
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Contact person for public queries
Name
90551
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Sam Holford
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Address
90551
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Middlemore Hospital
Private Bag 93311
Otahuhu
Auckland 1640
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Country
90551
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New Zealand
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Phone
90551
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+64 21 673 189
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Fax
90551
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Email
90551
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[email protected]
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Contact person for scientific queries
Name
90552
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Sam Holford
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Address
90552
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Middlemore Hospital
Private Bag 93311
Otahuhu
Auckland 1640
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Country
90552
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New Zealand
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Phone
90552
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+64 21 673 189
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Fax
90552
0
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Email
90552
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Confidentiality.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
1271
Ethical approval
376873-(Uploaded-01-02-2019-12-00-01)-Study-related document.pdf
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.
Download to PDF