Local Warming of Surgical Incisions
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Purpose
The purpose of this study is to determine if local warming of surgical wounds improves healing and helps prevent infection. The investigators want to see if warming surgical incisions improves oxygen levels and healing in skin close to the incision.
| Condition | Intervention | Phase |
|---|---|---|
|
Surgical Wound Infection |
Other: Warming of surgical incision Other: Warming dressing without actual warming |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Investigator, Outcomes Assessor) Primary Purpose: Prevention |
| Official Title: | Local Warming: Effects on Wound Infection and Healing |
- Surgical site infection [ Time Frame: Within 6 weeks of the surgical procedure ] [ Designated as safety issue: No ]
- Wound tissue response [ Time Frame: First 9 days after surgery ] [ Designated as safety issue: No ]
| Enrollment: | 146 |
| Study Start Date: | October 2005 |
| Study Completion Date: | November 2009 |
| Primary Completion Date: | November 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Local incision warming
Local warming applied to surgical incision for 6 treatments beginning in post anesthesia recovery through the second postoperative day.
|
Other: Warming of surgical incision
A warming pack (chemical activation) is applied to the dressing over the surgical incision, warming to 38 degrees C, for a period of 90 minutes times 6 treatments. The first treatment occurs in the PACU.
|
|
Active Comparator: No warming to surgical incision
Incisions covered with same postoperative dressing as in Arm 1 but without warming treatments.
|
Other: Warming dressing without actual warming
The same type of surgical incision dressing is used but no warming treatments are administered.
|
Detailed Description:
Surgical site infections (SSI) account for 37% of US hospital infections and increase morbidity and cost. High rates (10-22%) of SSI are associated with colorectal surgery and obesity. Bacterial resistance requires oxygen and higher tissue oxygen limits infection in general surgery patients. Control of core and local temperature may increase infection resistance by modulating perfusion, oxygenation, angiogenesis and immune cell responses. Perioperative hypothermia reduces tissue oxygen while normothermia lowers SSI rates. Warming injured tissues locally may offer additional benefit. Warming incisions immediately after surgery and intermittently for two days after gastric bypass or colectomy surgery reduced infection rates in a pilot sample. Systematic study of clinical outcomes and potential mechanisms in a larger study is lacking and is the focus of the current study.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- 18 and older,
- scheduled for bariatric, colon or gynecological surgery,
- able to speak and read English.
Exclusion Criteria:
- glucocorticoids greater than 5 mg per day,
- albumin below 3.0,
- creatinine above 2.5 mg/dl,
- history of pulmonary edema.
Contacts and Locations
More Information
No publications provided
| Responsible Party: | JoAnne Whitney, University of Washington |
| ClinicalTrials.gov Identifier: | NCT01026259 History of Changes |
| Other Study ID Numbers: | 29991-A |
| Study First Received: | December 2, 2009 |
| Last Updated: | December 3, 2009 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by University of Washington:
|
Surgical site infection wound healing tissue oxygen |
angiogenesis flow cytometry immunohistochemistry |
Additional relevant MeSH terms:
|
Surgical Wound Infection Wound Infection Infection |
Postoperative Complications Pathologic Processes Wounds and Injuries |
ClinicalTrials.gov processed this record on May 21, 2013