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Trial registered on ANZCTR
Registration number
ACTRN12616001391460p
Ethics application status
Not yet submitted
Date submitted
5/10/2016
Date registered
7/10/2016
Date last updated
7/10/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
Randomized trial of pre-operative Microdacyn versus standard care for prevention of intra-operative wound contamination and post-operative infection in clean surgical procedures
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Scientific title
Randomized trial of pre-operative Microdacyn versus standard care for prevention of intra-operative wound contamination and post-operative infection in clean surgical procedures
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Secondary ID [1]
290268
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Nil known
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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:
Intra-operative wound contamination
300497
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Post-operative wound infection
300498
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Condition category
Condition code
Infection
300357
300357
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0
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Studies of infection and infectious agents
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
To compare the efficacy of additional Microdacyn with standard practices for prevention of
intra-operative wound contamination in clean surgical procedures. Microdacyn hydrogel (Oculus, Mexico) will be applied by the patient to the skin at the site of the imminent surgical incision.
Arm 1. Standard care + Microdacyn applied twice daily for 7 days pre-operatively
Arm 2. Standard care + Microdacyn applied four times daily for 2 days pre-operatively
Arm 3. Standard care + Microdacyn applied once pre-operatively on the day of surgery
Arm 4. Standard care (no Microdacyn)
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Intervention code [1]
296065
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Prevention
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Comparator / control treatment
Control: Current standard treatment. This includes skin preparation immediately pre-operatively with alcohol + chlorhexidine, prophylactic antibiotics (mostly cefazolin), pre-operative nasal povidone iodine for prosthetic joint surgery and antiseptic sutures
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Control group
Active
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Outcomes
Primary outcome [1]
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Compare the mean number of bacteria isolated from wound swabs in the four study groups.
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Assessment method [1]
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Timepoint [1]
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2x swabs taken at the start of the operation and 2x swabs taken at the end of the operation
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Secondary outcome [1]
328191
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Incidence of post-operative wound infection in the four study groups. The assistants will contact each patient and enquire about symptoms of wound infection. Patients will also be asked to notify the lead investigator if symptoms of wound infection occur. Wound infection will be determined according to formal New Zealand definitions for a post-operative clean wound infection (based on National Healthcare Safety Network (CDC) definitions 2015).
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Assessment method [1]
328191
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Timepoint [1]
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21 to 28 days and 1 year post-operative
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Secondary outcome [2]
328192
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Incidence of treatment-emergent adverse events (TEAE, such as skin discomfort, itch or rash) in the four study groups. The assistants will contact each patient and enquire about TEAE. Patients will also be asked to notify the lead investigator or the research assistants if any TEAE occur.
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Assessment method [2]
328192
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Timepoint [2]
328192
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1 to 2 days pre-operatively and 21 to 28 days post-operative
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Eligibility
Key inclusion criteria
Able to provide informed consent; willingness to take part.
To undergo a clean elective surgical procedure (e.g. joint prosthesis, arthroscopy, tendon repair, internal fixation, laminectomy, spinal fusion, pacemaker insertion, thyroid, breast surgery)
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Minimum age
16
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?
No
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Key exclusion criteria
Pregnancy or breastfeeding.
Past adverse reaction to Microdacyn, a cephalosporin antibiotic or chlorhexidine.
Unable to receive cefazolin as pre-operative intravenous prophylaxis (e.g. previous severe adverse reaction to a penicillin antibiotic).
Suspected current or previous infection on the overlying skin or in the deep tissues at the operation site.
At least one dose of a systemic antibiotic in the 4 days before the start of the trial (other than routine pre-operative prophylaxis).
The operation site is covered by plaster of Paris or a dressing during the 3 days before the operation.
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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)
Allocation concealment will be achieved by the research assistant contacting the holder of the allocation schedule, who will be off-site
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple computerized sequence generation, stratified by operation type (shoulder
procedure, other joint prosthesis insertion, other orthopaedic procedure, non-orthopaedic surgical procedure) and in blocks (www.random.org – integer sets).
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Masking / blinding
Open (masking not 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
Phase 4
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
An almost identical trial to this one was undertaken in November 2016 to January 2016. The number of swab samples with moderate to heavy growth (more than 11 colonies on at least one plate) was 20 of 130 (15%) in the standard group and 4 of 124 (3%) in the Microdacyn group. No statistical analysis has been done yet on these results. In the current study, there will be three Microdacyn groups with different duration of pre-operative treatment (a dosing study) and we expect similar efficacy compared with control in the 2-day and 7-day groups.
Standard descriptive statistics including means, medians, ranges, frequencies and percentages will be used to summarise baseline and post randomization measures. Outcomes will be compared between randomized groups using Chi-square, fisher’s exact tests and Mann-Whitney U tests as appropriate. A two-tailed p-value <0.05 will be taken to indicate statistical significance.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
7/11/2016
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Actual
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Date of last participant enrolment
Anticipated
7/02/2017
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Actual
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Date of last data collection
Anticipated
10/02/2018
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Actual
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Sample size
Target
150
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
8294
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New Zealand
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State/province [1]
8294
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Nelson
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Funding & Sponsors
Funding source category [1]
294640
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Government body
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Name [1]
294640
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Accident Compensation Corporation
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Address [1]
294640
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Justice Centre
19 Aitken St
PO Box 242
Wellington 6140
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Country [1]
294640
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New Zealand
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Primary sponsor type
Individual
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Name
Richard Everts
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Address
Nelson Bays Primary Health
PO Box 1776
Nelson 7040
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Country
New Zealand
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Secondary sponsor category [1]
293504
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None
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Name [1]
293504
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Address [1]
293504
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Country [1]
293504
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
296075
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New Zealand Health and Disability Ethics Committee
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Ethics committee address [1]
296075
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Ethics committee country [1]
296075
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New Zealand
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Date submitted for ethics approval [1]
296075
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10/10/2016
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Approval date [1]
296075
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Ethics approval number [1]
296075
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Summary
Brief summary
Background: Infections after surgery, especially prosthesis surgery, are uncommon but potentially devastating. The bacteria that cause most of these infections are thought to enter the wound during the operation. Routine peri-operative anti-septic and antibiotic procedures do not eradicate bacteria hiding under the skin surface in hair follicles and sweat glands. These bacteria leak into the wound during the operation. In a randomized, controlled trial 9 months ago (unpublished to date), we found 2 days of pre-operative Microdacyn reduced the quantity of the bacteria that contaminated 'clean' wounds by 80%. We wish to perform this study in a new and larger group of participants undergoing a wider range of surgical procedures and compare different doses and durations of Microdacyn . Protocol: Randomized trial of Microdacyn (3 dose arms) versus standard care for prevention of intraoperative wound contamination in clean surgical procedures Trial sites: Nelson Hospital, and Manuka St Hospital, Nelson 7010 Laboratory: Medlab South, Nelson Hospital, Objectives of the trial To compare the efficacy of additional Microdacyn with standard practices for prevention of intra-operative wound contamination in clean surgery. Trial design: A randomized, unblinded, four-armed, parallel trial of efficacy, including 150 patients. This trial is designed to be run according to the quality standards of Good Clinical Practice and the Declaration of Helsinki for human trials. Primary endpoint 1. Bacterial contamination of intra-operative wound swabs. Secondary endpoints 1. Post-operative wound infection. 2. Treatment-emergent adverse events (TEAE). Hypothesis: Prophylactic treatment with Microdacyn reduces contamination of surgical fields; a longer course of treatment will be more effective than a single dose
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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 Richard Everts
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Address
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Nelson Bays Primary Health
PO Box 1776
Nelson 7040
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Country
69462
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New Zealand
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Phone
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+64 3 5391170
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Fax
69462
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Email
69462
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[email protected]
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Contact person for public queries
Name
69463
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Richard Everts
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Address
69463
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Nelson Bays Primary Health
PO Box 1776
Nelson 7040
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Country
69463
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New Zealand
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Phone
69463
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+64 3 5391170
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Fax
69463
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Email
69463
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[email protected]
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Contact person for scientific queries
Name
69464
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Richard Everts
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Address
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Nelson Bays Primary Health
PO Box 1776
Nelson 7040
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Country
69464
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New Zealand
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Phone
69464
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+64 3 5391170
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Fax
69464
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Email
69464
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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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