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Trial registered on ANZCTR
Registration number
ACTRN12611000595910
Ethics application status
Approved
Date submitted
1/06/2011
Date registered
9/06/2011
Date last updated
1/04/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
Efficacy of oral antibiotic prophylaxis in prevention of surgical site infection following skin lesion excisions at high risk of infection in general practice
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Scientific title
A primary care study of skin lesions excisions from the lower limb and groin and excisions from any site in diabetics comparing the effect of a 2g oral dose of cephalexin administered 30-60 minutes prior to the operation and a placebo in the prevention of subsequent surgical site infection
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Secondary ID [1]
262298
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Nil
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Universal Trial Number (UTN)
U1111-1121-7889
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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 site infections following skin lesion excisions from the lower limb or groin in general practice
267955
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Surgical site infections following skin lesion excisions from any site in diabetics in general practice
267956
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Condition category
Condition code
Infection
268094
268094
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0
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Studies of infection and infectious agents
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Surgery
268134
268134
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0
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Other surgery
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Metabolic and Endocrine
268135
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
2 g oral dose cephalexin (administered in 4 x 500mg capsules) 30-60 minutes prior to skin lesion excisions from the lower limb or groin or any site from diabetics
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Intervention code [1]
266652
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Prevention
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Comparator / control treatment
Inert gel capsule, identical to that containing cephalexin.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Presence or absence of wound infection defined as:
Purulent discharge from the wound must be present
OR
Atleast one of the following signs and symptoms of infection
Pain/Tenderness
Localised swelling
Heat
Erythema >1cm
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Assessment method [1]
266838
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Timepoint [1]
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When patients return for suture removal (10 days for excisions from back and shin, 7 days for all other sites) or earlier if patients re-present due to perceived infection (date which wound is assessed at will be recorded)
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Secondary outcome [1]
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Wound grade
1. No infection or erythema
2. Stitch abscess
3. Less than 1cm of erythema with no pain, heat or swelling
4. Less than 1 cm erythema from the wound margin with pain, heat or swelling
5. Greater than 1 cm erythema from the wound margin with no pain, heat or swelling
6. Greater than 1 cm erythema from the wound margin with pain, heat or swelling
7.Deep infection or systemic symptoms (including lymphangitis, regional lymphadenopathy)
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Assessment method [1]
276490
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Timepoint [1]
276490
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When patients return for suture removal (10 days for excisions from back and shin, 7 days for all other sites) or earlier if patients re-present due to perceived infection (date which wound is assessed at will be recorded)
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Secondary outcome [2]
276492
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Prescription of antibiotics for wound infection
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Assessment method [2]
276492
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Timepoint [2]
276492
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When patients return for suture removal (10 days for excisions from back and shin, 7 days for all other sites) or earlier if patients re-present due to perceived infection (date which wound is assessed at will be recorded)
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Secondary outcome [3]
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Additional consultations required for wound to be reviewed or re-dressed due to infection
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Assessment method [3]
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Timepoint [3]
276493
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Recorded each time patients re-presents primarily in order to have wound reviewed or re-dressed due to diagnosed infection at time or suture removal or earlier for up to 30 days after skin lesion excision
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Eligibility
Key inclusion criteria
1. >18 yrs old
2. Capable of informed consent
3. Presenting for excision of a minor skin lesion from lower leg or groin OR Diabetic presenting for skin lesion excision from any site
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Currently taking antibiotics or clinically indicated for antibiotic treatment following excision
Repair of lacerations or lesion considered contaminated/infected prior to surgery
Excision not requiring sutures (E.g. shave biopsy or curette)
Excision of sebaceous cyst
Patient unable to return for suture removal
Penicillin or cephalosporin allergy
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Consecutive patients presenting at participating general practices are eligible for the trial provided the meet inclusion/exclusion criteria
Practices doctors and nurses responsible for recruiting patients to the trial
If interested in participating, patient will be asked to give signed consent before being allocated a consecutive number by the enrolling nurse or doctor
This number will correspond to a numbered container containing the capsules the patient will receive upon returning to have their skin lesion/s excised. The contents of the capsules held within each numbered container will be determined using a computer generated random sequence and will be blinded to all parties directly involved in allocation, administration of capsules and outcome assessment. In the event that an adverse event occurs the trial coordinators will inform the treating doctor of the contents of the capsule and the participant will be removed from the trial.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A sequence of consecutive numbers randomised to either intervention or control will be generated using a computer randomisation. This sequence will be used to create numbered containers which will containing identical capsules filled with either the intervention or control substance depending on the group to which the number was allocated during computer randomisation. Each enrolled patient will be assigned a consecutive number and will receive the capsules from the corresponding numbered container upon return for skin lesion excision.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/08/2011
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Actual
4/10/2011
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Date of last participant enrolment
Anticipated
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Actual
31/05/2012
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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James Cook University
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Address [1]
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School of Medicine and dentistry
Mackay Base Hospital
Bridge Rd
Mackay QLD 4740
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Country [1]
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Australia
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Primary sponsor type
University
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Name
James Cook University
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Address
School of Medicine and dentistry
Mackay Base Hospital
Bridge Rd
Mackay QLD 4740
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
266217
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Country [1]
266217
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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James Cook University Human Ethics Committee
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Ethics committee address [1]
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Human Ethics and Grants Administrator Research Office Room 021 A Ground Floor Kevin Stark Research Building (DB019) James Cook University Townsville, Qld 4811
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Ethics committee country [1]
269134
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Australia
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Date submitted for ethics approval [1]
269134
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Approval date [1]
269134
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05/05/2011
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Ethics approval number [1]
269134
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H4113
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Summary
Brief summary
Certain risk factors are known to be associated with a predictably high rate of surgical wound infection following minor dermatological procedures such as skin lesion excision. The use of oral antibiotic prophylaxis has been suggested as one way of reducing this risk of infection. This project seeks to test the efficacy of such recommendations in the form of a double blind randomised control trial. For the purposes of this trial the high risk group was defined as patients undergoing skin lesion excisions from the lower limb and groin and diabetics having skin lesion excisions from any site. The intervention will consist of a 2g oral dose of cephalexin administered 30-60 minutes prior to the excision while the control will be an identical placebo. Wounds will be assessed for infection using a standardised criteria when patients return for suture removal or earlier if participants re-present due to perceived infection. A wound grading system will also be used and other information which may correlate with infection will also be recorded. This project aims to enrol 100 patients and is a pilot for a large scale multi-centre trial currently in planning.
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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
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Dr Samuel Smith
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Address
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Unit 29
159 Riverside Boulevard
Douglas, QLD 4814
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Country
32660
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Australia
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Phone
32660
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+61407256136
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Fax
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Email
32660
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[email protected]
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Contact person for public queries
Name
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Samuel Smith
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Address
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James Cook University
Unit 29
159 Riverside Boulevard
Douglas, QLD 4814
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Country
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Australia
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Phone
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+61 (0)407256136
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Fax
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+61 7 4885 7111
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Email
15907
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[email protected]
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Contact person for scientific queries
Name
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Samuel Smith
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Address
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Student Accommodation
School of Medicine and dentistry
Mackay Base Hospital
Bridge Rd
Mackay, QLD 4740
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Country
6835
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Australia
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Phone
6835
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+61 (0)407256136
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Fax
6835
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+61 7 4885 7111
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Email
6835
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
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.
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