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Trial registered on ANZCTR
Registration number
ACTRN12612000768897
Ethics application status
Approved
Date submitted
4/07/2012
Date registered
19/07/2012
Date last updated
19/07/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
Reducing Surgical Site Infection in Caesarean Section: Is there a role for antibacterial sutures?
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Scientific title
Does the use of antibacterial (Triclosan) impregnated sutures at the time of performing caesarean section reduce the incidence of surgical site infection in postpartum women when compared to standard sutures?
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Secondary ID [1]
280776
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Nil
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Universal Trial Number (UTN)
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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 infection after caesarean section.
285870
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Condition category
Condition code
Reproductive Health and Childbirth
286055
286055
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0
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Childbirth and postnatal care
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Infection
286056
286056
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0
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Studies of infection and infectious agents
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Surgery
287145
287145
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0
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Other surgery
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Use of Triclosan-coated sutures for closure of rectus muscle sheath and skin at caesarean section. Closure of the rectus sheath and skin usually takes about 10 minutes but does vary from case to case depending on the patient and the operator.
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Intervention code [1]
284286
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Treatment: Surgery
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Intervention code [2]
285202
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Prevention
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Comparator / control treatment
Use of standard, non-antibacterial, sutures for closure of the rectus muscle sheath and skin at caesarean section.
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Control group
Active
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Outcomes
Primary outcome [1]
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Surgical site infection.
Using the standard follow-up tool to our department - the "Lead Maternit Carer" (LMC) reviews the patient regularily once discharged over the 6 weeks post-partum. Any surgical site infection is reported back at 6 weeks.
The surgical site infection is defines as:
Superficial and Deep Surgical Site Infection: Infection within 30 days of operation.
Superficial - involves skin/sub-cut tissue of incision only and one of; purulent discharge, organisms isolated from aseptically obtained culture, pain or tenderness, localised swelling, redness, heat, superficial incision opened by surgeon unless culture negative, diagnosis of infection by attending physician/surgeon.
Deep - involves deep soft tissue and one of; purulant discharge, spontaneous dehiscence or deliberately opened in the presence of temp >38C or pain/tenderness unless culture negative, abscess found on examination during surgery, radiology or histopathology, diagnosis of deep infection by attending physician/surgeon.
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Assessment method [1]
286535
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Timepoint [1]
286535
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Wound infection within 30 days post-caesarean section reported back at 6 weeks post-partum by the LMC.
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Secondary outcome [1]
296105
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Wound/fascial dehiscence.
In event of suspected wound dehiscence the patient will be reviewed at Dunedin Hospital, Queen Mary Maternity Services and fascial dehiscence will be diagnosed by medical staff (independant medical examination).
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Assessment method [1]
296105
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Timepoint [1]
296105
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Within 30 days post-caesarean section.
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Eligibility
Key inclusion criteria
Elective, semi-elective and emergency caesarean sections in women seen and consented in an Antenatal Clinic or Antenatal Ward setting prior to presentation on the day of surgery. (E.g. including women undergoing emergency caesarean section during attempted vaginal birth after previous caesarean section if seen and consented in antenatal clinic on a prior occasion).
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Minimum age
18
Years
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Maximum age
45
Years
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Sex
Females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Pre-existing Type 1 or 2 Diabetes (not Gestational diabetes which should resolve post-delivery and remove the increased risk of infection post-operatively).
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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)
Information about the study will be passed to women either attending antenatal clinic or present on the antenatal ward and planned/high risk for a Caesarean section. Consent shall be taken if a woman agrees to enter the study and is not in labour.
Envelope method with variable block size – chosen to reduce any perceived complication of randomisation (especially in the case of Emergency Caesareans performed at night) and increase uptake.
Randomised by the circulating midwife, prepared by the scrub midwife and then blinded to the surgeon, woman undergoing caesarean and LMC.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Opaque envelope method with variable block size.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/08/2012
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
550
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
4136
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New Zealand
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State/province [1]
4136
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Otago
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Funding & Sponsors
Funding source category [1]
285549
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Hospital
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Name [1]
285549
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Dunedin Hospital, Research Project Initiative Award, Southland DHB.
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Address [1]
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Dunedin Hospital,
Great King Street,
Dunedin 9012.
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Country [1]
285549
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New Zealand
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Primary sponsor type
Individual
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Name
Jana Morgan
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Address
Women's Health Department,
Dunedin Hospital,
Great King Street,
Dunedin 9012.
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Country
New Zealand
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Secondary sponsor category [1]
284384
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Individual
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Name [1]
284384
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Helen Paterson
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Address [1]
284384
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Women's Health Department,
Dunedin Hospital,
Great King Street,
Dunedin 9012.
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Country [1]
284384
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
286727
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Central Regional Ethics Committee
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Ethics committee address [1]
286727
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Ministry of Health, PO Box 5013, 1 The Terrace, Wellington 6011.
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Ethics committee country [1]
286727
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New Zealand
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Date submitted for ethics approval [1]
286727
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13/03/2012
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Approval date [1]
286727
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Ethics approval number [1]
286727
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Summary
Brief summary
This trial is hoping to find out if a new type of antibacterial-coated stitch will help to reduce the risk of infection in the wound after Caesarean Section delivery. At the time of Caesarean Section we will pick, by chance, half of the women in the study to receive the coated stitch in place of the routine non-antibacterial stitch when closing the skin and deeper layers but not the uterus (womb). All other aspects of the care relating to the Caesarean Section will remain unchanged. The follow-up and post-operative care will remain as standard. 30 days after the operation we will collect information from the patient’s midwife/LMC about whether she has had any signs or symptoms that might suggest infection in the wound. Treatment of any infection will not be altered or delayed because of the trial. We will use this information to find out if the antibacterial stitch reduces the risk of infection for women after Caesarean Section. We hypothosise that the antibacterial stitch will reduce the occurance of wound infection.
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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
33788
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Address
33788
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Country
33788
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Phone
33788
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Fax
33788
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Email
33788
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Contact person for public queries
Name
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Jana Morgan
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Address
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Dunedin Hospital,
Great King Street,
Dunedin 9012.
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Country
17035
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New Zealand
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Phone
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+64 02102242419
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Fax
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Email
17035
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[email protected]
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Contact person for scientific queries
Name
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Jana Morgan
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Address
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Dunedin Hospital,
Great King Street,
Dunedin 9012.
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Country
7963
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New Zealand
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Phone
7963
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+64 21 022 42419
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Fax
7963
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Email
7963
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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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