This is a randomized (1:1 ratio), prospective, comparative, controlled, open-label study. The aim is to compare the efficacy of negative pressure therapy (PREVENA™) versus standard postoperative wound management on the wound healing after surgery for previously irradiated Soft Tissue Sarcoma (STS)
The gold standard treatment for primary non-metastatic STS is complete surgical resection. Peri-operative Radiation Therapy (RT) has been proved to improve local control . Nevertheless, the timing of RT, whether preoperative or postoperative, remains a debate. Both have similar local control efficacy, but preoperative RT results in lower rates of long-term fibrosis and lymphedema and improved joint mobility than postoperative RT. On the other hand, the adverse effect of pre-operative RT is a higher rate of wound post-operative complications and re-operations. Any effort to reduce the high rate of postoperative complications could offer the advantage of preoperative RT in terms of reduced long-term sequelae compared with postoperative RT without a higher wound complication rate postoperatively. Short retrospective series of Negative Pressure Wound Therapy (NPWT) after surgical resection of Soft Tissue Sarcoma (STS) have reported very encouraging results in preventing wound complications: patients treated with NPWT were less likely to develop wound complications than those who did not receive it. Both groups did not report an increased rate of local recurrence. The use of NPWT would also reduce the cost of care by avoiding complications. That's why the investigators propose this study comparing the use of a negative pressure dressing to a conventional dressing in patients with STS of the limbs or trunk resected after neo-adjuvant external radiotherapy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
166
PREVENA™ is a CE-marked class IIa medical device. The PREVENA™ Incision Management System is also intended to manage the environment of closed surgical incisions and surround intact skin in patients at risk for developing post-operative complications, such as infection, by maintaining a closed environment via the application of a negative pressure wound therapy system to the incision.
CHU Nantes
Nantes, Pays de Loire, France
RECRUITINGCentre Leon Berard
Lyon, Rhône-Alpes Auvergne, France
The efficacy of negative pressure therapy (PREVENA) versus standard postoperative wound management on the wound healing after surgery for previously irradiated STS
Assessed by major wound complications rate
Time frame: Within the 3-month postoperative period.
Three month deep infection rate
Assessed by the proportion of patients experiencing a second surgery for wound healing problem within 3 postoperative months
Time frame: At 3 months post-surgery visit
Three months secondary surgery for wound healing problem rate
Assessed by the proportion of patients experiencing a second surgery for wound healing problem within 3 postoperative months
Time frame: At 3 months post-surgery visit
Hospitalization duration
Defined as the number of hospitalization days from the date of surgery to the date of discharge
Time frame: At 3 months post-surgery visit
Time to complete wound healing
Defined as the interval from surgery to 100% healing (total wound closure with no need for dressing and any local care)
Time frame: Up to 27 months
Number and types of major wound complications (MWCs)
Assessed by a number and differens types of a major wound complications
Time frame: Up to 27 months
Quality of life using EQ-5D-5L
Assessed by EQ-5D-5L introduce by EuroQol Group in 2009 with five dimensions : mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has five levels : no problems, slight problems, moderate problems, severe problems and extreme problems. A minimum value is 0 and a maximum value is 100. A mean worst value is 0 and a better mean value is 100.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Institut de Cancérologie de l'Ouest - Pays de Loire
Angers, France
RECRUITINGInstitut Bergonié
Bordeaux, France
RECRUITINGCHRU Tours Hôpital Trousseau
Chambray-lès-Tours, France
RECRUITINGCentre Jean Perrin
Clermont-Ferrand, France
RECRUITINGCentre Georges François Leclerc
Dijon, France
RECRUITINGCentre Oscar Lambert
Lille, France
RECRUITINGCHU Limoges
Limoges, France
RECRUITINGInstitut du Cancer de Montpellier
Montpellier, France
RECRUITING...and 5 more locations
Time frame: At 28 days and 3 months after surgery for each patients
Incidence of Adverse Events
Defined by the number of patients with Adverse Events (any type and any grade using the NCI-CTC AE scale version 5.0)
Time frame: Up to 27months
Quality of life using FACT-G
Assessed by FACT-G : Functionnal Assesment of Cancer Therapy with 27 items. There are four domains of HRQOL in cancer patients: Physical, social, emotional, and functional well-being. A minimum value is 0 and a maximum value is 4. A mean worst value is 0 and a better mean value is 108.
Time frame: At 28 days and 3 months after surgery for each patients