This study is a prospective, multi-center, two-arm, unblinded, and randomized controlled trial with a goal of evaluating the impact of a closed incision negative pressure dressing (PREVENA) on incidence of post-operative wound complications and medical costs in patients undergoing lower extremity amputation.
This is a prospective, multi-center, two-arm, unblinded, randomized controlled trial to evaluate the impact of a closed incision negative pressure dressing (PREVENA™ PEEL \& PLACE™ Dressing Kit) on incidence of post-operative wound complications in patients undergoing above-the-knee (AKA) or below-the-knee (BKA) amputation. Up to 440 subjects at approximately five (5) participating sites will be randomized to receive either the Prevena dressing or a standard care dressing. The incision will be assessed for complications at post-op day 5 or day 6 and at approximately 30 days after discharge. The primary outcome of this study is reported wound complications, including dehiscence (opening of the incision), seroma, lymph leak, infection (deep or superficial), hematoma (blood clots), ischemia (decreased blood supply), and necrosis (tissue death) A major complication is defined as any wound complication requiring intravenous or oral antibiotics, reoperation and/or hospital readmission. All data (demographics, medical history, and clinical outcomes) will be collected via medical record review
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
272
In combination with a negative pressure pump (V.A.C. ® Therapy Unit, KCI USA, Inc.), the Prevena dressing is designed to provide negative pressure wound therapy (NPWT) over surgical incisions (incisional NPWT).
Westchester Medical Center
Valhalla, New York, United States
Thomas Jefferson University/Hospital
Philadelphia, Pennsylvania, United States
Gemelli Hospital
Roma, RM, Italy
Overall Rate of Wound Complications
Presence of any of the following post-procedure: * Dehiscence (skin or fascia) * Seroma * Lymph leak * Infection (superficial or deep, using CDC Surgical Site Infection criteria) * Hematoma * Ischemia * Necrosis
Time frame: 30 days post procedure
Length of Stay (LOS)
index LOS is defined as days from operation to discharge; 30d LOS is defined as the index LOS plus all readmission days within 30d related to any wound complication
Time frame: 30 days post procedure
30-day Return to Operating Room (ROR)
Reoperation for wound complication within 30 days involving incision and drainage in the operating room; opening the skin to drain a superficial soft tissue infection at bedside or in the office is not considered reoperation
Time frame: 30 days post procedure
30-day Hospital Readmissions
Rehospitalization for wound complication within 30 days
Time frame: 30 days post procedure
Incidence of Skin Dehiscence
Individual rates of the incidence of skin dehiscence
Time frame: 30 days post procedure
Incidence of Fascial Dehiscence
Individual incidence rate of fascial dehiscence
Time frame: 30 Days
Incidence of Superficial Skin Infection
Individual incidence of superficial skin infection
Time frame: 30 days
Incidence of Deep Skin Infection
Individual incidence of deep skin infection
Time frame: 30 days
Incidence of Seroma
Individual incidence of seroma
Time frame: 30 Days
Incidence of Hematoma
Individual Incidence of Hematoma
Time frame: 30 days
Incidence of Necrosis
Individual incidence of Necrosis
Time frame: 30 Days
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