Comparative Effectiveness Multicenter Trial for Adhesion Characteristics of Ventral Hernia Repair Mesh
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Purpose
The proposed study will compare the benefits, harms, and comparative effectiveness of intraperitoneal barrier-coated and non-barrier coated ventral hernia repair (VHR) mesh in reducing adhesions, adhesion-related complications, and adhesiolysis sequelae in actual patient subpopulations and clinical circumstances. A subset of the data will be analyzed to compare the benefits, harms, and comparative effectiveness of the laparoscopic and open approaches to adhesiolysis. A comprehensive array of health-related risk factors and patient-centered outcomes will be assessed in the investigators diverse patient population for proper multivariate data analysis.
Specific Aim I: To evaluate and compare the adhesion characteristics of intraperitoneal barrier-coated versus non-barrier-coated mesh during abdominal re-exploration after prior ventral hernia repair.
Specific Aim II: To evaluate and compare the adhesion-related complications and adhesiolysis-related complications of intraperitoneal barrier-coated versus non-barrier-coated mesh during abdominal re-exploration after prior ventral hernia repair.
Specific Aim III: To determine the comparative effectiveness of intraperitoneal barrier-coated versus non-barrier-coated ventral hernia repair mesh in reducing adhesions, adhesion-related complications, and adhesiolysis sequelae in actual patient subpopulations and clinical circumstances.
Specific Aim IV: To evaluate and compare the adhesiolysis-related complications of the laparoscopic and open approaches to adhesiolysis during abdominal re-exploration after prior ventral hernia repair.
Specific Aim V: To determine the comparative effectiveness of the laparoscopic and open approaches to adhesiolysis during abdominal re-exploration after prior ventral hernia repair.
| Condition | Intervention |
|---|---|
|
Ventral Hernia Adhesions |
Procedure: Clinically-Indicated Abdominal Re-Exploration Surgery |
| Study Type: | Observational |
| Study Design: | Observational Model: Cohort Time Perspective: Prospective |
| Official Title: | A Prospective Multicenter Trial to Evaluate Adhesion Characteristics and Adhesiolysis-related Complications of Barrier-coated and Non-barrier-coated Intraperitoneal Mesh During Abdominal Re-exploration After Prior Ventral Hernia Repair |
- Mesh adhesiolysis time:Mesh surface area [ Time Frame: Intraoperatively (day 1) ] [ Designated as safety issue: No ]
- Mesh Contracture [ Time Frame: Intraoperatively (day 1) ] [ Designated as safety issue: No ]
- Mesh adhesion tenacity [ Time Frame: Intraoperatively (day 1) ] [ Designated as safety issue: No ]
- Percentage mesh surface area covered with adhesions [ Time Frame: Intraoperatively (day 1) ] [ Designated as safety issue: No ]
- Adhesiolysis time to abdominal wall [ Time Frame: Intraoperatively (day 1) ] [ Designated as safety issue: No ]
- Adhesiolysis time to mesh [ Time Frame: Intraoperatively (day 1) ] [ Designated as safety issue: No ]
- Incidence of adhesiolysis-related intra-operative complications [ Time Frame: Intraoperatively (day 1) ] [ Designated as safety issue: No ]
- Length of stay of hospital admission [ Time Frame: 30 day postoperative ] [ Designated as safety issue: No ]
- Length of stay in ICU [ Time Frame: 30 day postoperative ] [ Designated as safety issue: No ]
- Interval to return to bowel function [ Time Frame: 30 day postoperative ] [ Designated as safety issue: No ]
- Interval to return to independent ambulation or activities of daily living [ Time Frame: 30 day postoperative ] [ Designated as safety issue: No ]
- Interval to return to work or routine physical activity [ Time Frame: 30 day postoperative ] [ Designated as safety issue: No ]
- Incidence of postoperative complications [ Time Frame: 30 day, 12 month, and 24 month postoperative ] [ Designated as safety issue: No ]
- Incidence of surgical site infection [ Time Frame: 30 day, 12 month, and 24 month postoperative ] [ Designated as safety issue: No ]
- Incidence of initiation of antibiotics, blood and TPN [ Time Frame: 30 day, 12 month, and 24 month postoperative ] [ Designated as safety issue: No ]
- Incidence of bedside procedures to address a postoperative surgical complication [ Time Frame: 30 day, 12 month, and 24 month postoperative ] [ Designated as safety issue: No ]
- Incidence of surgery under local anesthesia to address a postoperative complication [ Time Frame: 30 day, 12 month, and 24 month postoperative ] [ Designated as safety issue: No ]
- Incidence of single system organ failure [ Time Frame: 30 day, 12 month, and 24 month postoperative ] [ Designated as safety issue: No ]
- Incidence of multiple-system organ failure [ Time Frame: 30 day, 12 month, and 24 month postoperative ] [ Designated as safety issue: No ]
- Mortality rate [ Time Frame: 30 day, 12 month, and 24 month postoperative ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 360 |
| Study Start Date: | May 2011 |
| Estimated Study Completion Date: | May 2016 |
| Estimated Primary Completion Date: | May 2016 (Final data collection date for primary outcome measure) |
| Groups/Cohorts | Assigned Interventions |
|---|---|
| Abdominal surgery after prior VHR with barrier-coated mesh |
Procedure: Clinically-Indicated Abdominal Re-Exploration Surgery
This is a prospective observational study. Abdominal re-exploration surgery is clinically-indicated and planned as the standard of care for the patients regardless of their decision to participate in the study.
Other Names:
|
| Abdominal surgery after prior VHR with nonbarrier-coated mesh |
Procedure: Clinically-Indicated Abdominal Re-Exploration Surgery
This is a prospective observational study. Abdominal re-exploration surgery is clinically-indicated and planned as the standard of care for the patients regardless of their decision to participate in the study.
Other Names:
|
| Lap adhesiolysis during abdominal surgery after prior VHR |
Procedure: Clinically-Indicated Abdominal Re-Exploration Surgery
This is a prospective observational study. Abdominal re-exploration surgery is clinically-indicated and planned as the standard of care for the patients regardless of their decision to participate in the study.
Other Names:
|
| Open adhesioloysis during abdominal surgery after prior VHR |
Procedure: Clinically-Indicated Abdominal Re-Exploration Surgery
This is a prospective observational study. Abdominal re-exploration surgery is clinically-indicated and planned as the standard of care for the patients regardless of their decision to participate in the study.
Other Names:
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
Investigators' patient population
Inclusion Criteria:
- greater than or equal to 18 years of age
- prior ventral hernia repair with intraperitoneal placement of mesh (open or laparoscopic approach; absorbable barrier-coated mesh, permanent barrier-coated composite mesh, permanent barrier-coated noncomposite mesh, non-barrier-coated polypropylene mesh, or biologic mesh)
- subsequent abdominal procedure requiring exposure of entire surface area of intraperitoneal mesh
Exclusion Criteria:
- less than 18 years of age
- inability to verify intraperitoneal mesh type or location
- active abdominal wound infection or open abdominal wound
Contacts and Locations| Contact: Jaime A Cavallo, M.D. | 314-362-8381 | cavalloj@wudosis.wustl.edu |
| Contact: Sara Baalman, M.A. | 314-362-8359 | baalmans@wudosis.wustl.edu |
| United States, Arizona | |
| Mayo Clinic Scottsdale | Recruiting |
| Phoenix, Arizona, United States, 85054 | |
| Principal Investigator: Kristi L Harold, M.D. | |
| United States, California | |
| University of California-San Diego | Recruiting |
| San Diego, California, United States, 92103 | |
| Principal Investigator: Garth Jacobsen, M.D. | |
| Principal Investigator: Santiago Horgan, M.D. | |
| United States, Massachusetts | |
| Baystate Medical Center | Recruiting |
| Springfield, Massachusetts, United States, 01199 | |
| Principal Investigator: David B Earle, M.D. | |
| United States, Missouri | |
| University of Missouri at Columbia | Recruiting |
| Columbia, Missouri, United States, 65212 | |
| Principal Investigator: Arthur J Rawlings, M.D., Mdiv | |
| Washington University | Recruiting |
| St. Louis, Missouri, United States, 63110 | |
| Contact: Sara Baalman, M.A. 314-362-8539 baalmans@wudosis.wustl.edu | |
| Principal Investigator: Jaime A Cavallo, M.D. | |
| Principal Investigator: Brent D Matthews, M.D., F.A.C.S. | |
| United States, New York | |
| Mount Sinai Medical Center | Recruiting |
| New York, New York, United States, 10028 | |
| Principal Investigator: Brian Jacob, M.D. | |
| Principal Investigator: Mark Reiner, M.D. | |
| Principal Investigator: Joel Bauer, M.D. | |
| United States, South Carolina | |
| Greenville Medical Center | Recruiting |
| Greenville, South Carolina, United States, 29615 | |
| Principal Investigator: Alfredo M Carbonell, D.O., F.A.C.S., F.A.C.O.S. | |
| Principal Investigator: William S Cobb, M.D., F.A.C.S. | |
| Principal Investigator: | Brent D Matthews, M.D. | Washington University School of Medicine |
| Principal Investigator: | Jaime A Cavallo, M.D. | Washington University School of Medicine |
More Information
No publications provided
| Responsible Party: | Jaime Cavallo, Senior Research Resident, Washington University School of Medicine |
| ClinicalTrials.gov Identifier: | NCT01355939 History of Changes |
| Other Study ID Numbers: | 2011-02112, 1KM1CA156708-01 |
| Study First Received: | April 26, 2011 |
| Last Updated: | October 31, 2011 |
| Health Authority: | United States: Institutional Review Board United States: Federal Government |
Keywords provided by Washington University School of Medicine:
|
Adhesions Hernia Adhesiolysis Intraperitoneal Mesh Abdominal Re-exploration Mesh |
Barrier-Coated Mesh Non-Barrier-Coated Mesh Laparoscopic Approach Open Approach Abdominal Re-Exploration Surgery |
Additional relevant MeSH terms:
|
Tissue Adhesions Hernia Hernia, Ventral Cicatrix |
Fibrosis Pathologic Processes Pathological Conditions, Anatomical Hernia, Abdominal |
ClinicalTrials.gov processed this record on June 18, 2013