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Trial registered on ANZCTR
Registration number
ACTRN12620001207909
Ethics application status
Approved
Date submitted
18/09/2020
Date registered
13/11/2020
Date last updated
13/11/2020
Date data sharing statement initially provided
13/11/2020
Date results provided
13/11/2020
Type of registration
Retrospectively registered
Titles & IDs
Public title
Topical Skin Adhesive versus Nylon Sutures For Incision Closure In Forefoot Surgery: A Randomised Controlled Trial
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Scientific title
A single blinded, prospective randomised controlled trial of evaluation of wound healing and pain at post-operative dressing change between skin closure with synthetic polybutester sutures and octyl cyanoacrylate tissue adhesive in patients who have elective open forefoot surgery
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Secondary ID [1]
302350
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None
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Universal Trial Number (UTN)
U1111-1258-4232
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Trial acronym
STICS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Elective forefoot surgery
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hallux valgus
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First Metatarsophalangeal joint fusion
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Condition category
Condition code
Surgery
317086
317086
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0
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Surgical techniques
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Skin
317087
317087
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0
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Normal skin development and function
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intervention: skin closure reinforcement with 2- Octyl-cyanoacrylate tissue adhesive following subcuticular skin closure with absorbable 3.0 vicryl rapide following elective open forefoot surgery (either hallux valgus correction or first MTP arthrodesis). All wound closure (in either group) was conducted by a single surgeon (the Principal Investigator, an orthopaedic foot and ankle surgeon). Study data including intervention type was entered into a study-specific database following the intervention. Adherence was confirmed at the pre-specified follow up times.
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Intervention code [1]
318639
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Treatment: Surgery
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Comparator / control treatment
Control : skin closure reinforcement with synthetic polybutester sutures following subcuticular skin closure with absorbable 3.0 vicryl rapide following elective open forefoot surgery (either hallux valgus correction or first MTP arthrodesis)
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Control group
Active
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Outcomes
Primary outcome [1]
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Visual analogue scale for pain
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Assessment method [1]
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Timepoint [1]
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two weeks following surgery
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Secondary outcome [1]
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Wound evaluation using validated wound evaluation score (Modified Hollander Wound Score)
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Assessment method [1]
387083
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Timepoint [1]
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two weeks following surgery
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Secondary outcome [2]
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Time taken for each method of skin closure. This was measured using a digital stopwatch and recorded on each CRF and entered onto the study database following each operation
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Assessment method [2]
387084
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Timepoint [2]
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At the time of surgery
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Secondary outcome [3]
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Time taken to undergo dressing change in first outpatient clinic appointment. This was measured using a digital stopwatch and recorded on each CRF and entered onto the study database following each operation
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Assessment method [3]
387085
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Timepoint [3]
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Two weeks following surgery
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Secondary outcome [4]
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Patient satisfaction with incision cosmesis. This was measured using a 5-point Likert Scale: Very Dissatisfied, Dissatisfied, Neutral, Satisfied, Very Satisfied
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Assessment method [4]
387086
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Timepoint [4]
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six weeks following surgery
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Eligibility
Key inclusion criteria
The inclusion criteria for this study were:
- Age greater than 18 years
- Undergoing elective open forefoot surgery; either Scarf ± Akin osteotomy for hallux valgus or first metatarsophalangeal joint arthrodesis)
- Informed consent for participation in the RCT
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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?
No
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Key exclusion criteria
The exclusion criteria for this study were:
- Revision forefoot surgery
- Percutaneous forefoot surgery
- Patients undergoing surgery not involving the first ray
- Cognitive impairment preventing patient from adhering to post operative instructions or completing patient reported outcome scores
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Study design
Purpose of the study
Treatment
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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 was performed using sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation was carried out be by block permuted computer generated method with sealed envelopes being used to choose grouping. Each patient was randomised in theatre into either the intervention or control group.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The independent t-test for parametric data was used to compare continuous variables. Fisher’s exact test and chi-squared analysis were used to assess categorical variables. All statistical analyses were performed using the Python SciPy package2. Statistical significance was defined as a P value of less than 0.05.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
31/01/2018
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Date of last participant enrolment
Anticipated
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Actual
24/10/2018
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Date of last data collection
Anticipated
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Actual
5/12/2018
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Sample size
Target
68
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Accrual to date
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Final
84
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
306779
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Charities/Societies/Foundations
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Name [1]
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The Friends of the Mater Foundation
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Address [1]
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The Friends of the Mater Foundation
PO Box 958,
North Sydney,
NSW 2059
Australia
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Country [1]
306779
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Australia
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Primary sponsor type
Hospital
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Name
St Vincent's Hospital Sydney
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Address
St Vincent's Hospital Sydney
390 Victoria Street,
Darlinghurst,
NSW 2010
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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]
307331
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None
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Address [1]
307331
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Country [1]
307331
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
306942
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St Vincent's Hospital Human Research Ethics Committee
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Ethics committee address [1]
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St Vincent's Hospital Sydney, 390 Victoria Street, Darlinghurst, NSW 2010
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Ethics committee country [1]
306942
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Australia
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Date submitted for ethics approval [1]
306942
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04/05/2017
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Approval date [1]
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09/05/2017
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Ethics approval number [1]
306942
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SVH File no 17/063, National Ethics Application Form AU/1/94FB24
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Summary
Brief summary
Postoperative infections are the most common cause of complications in surgical patients and result in an average increase of four days in the hospital. Foot and ankle surgery may have a higher infection rate than other surgical areas since surgical preparation cannot fully reduce the bacterial load prior to incision. Due to the increased rate of infection and wound breakdown surgeons routinely reinforce absorbable subcuticular wound closures with non-absorbable skin sutures. Removal of these sutures can be painful and leave unsightly scars. 2- Octyl-cyanoacrylate tissue adhesive is available in Australia as an alternative to skin suturing for wound closure. There have been mixed results with this product with some studies showing good wound closure and low infection rates and others showing high rates of wound dehiscence and infection. The high rates of wound dehiscence with tissue adhesive has been postulated to be due to high wound tension. We believe that tissue adhesive may be successful an occlusive reinforcement after proper skin closure with appropriate methods to reduce tension such as subcuticular stitching. There have been no studies looking at using tissue adhesive in this fashion in foot and ankle surgery. The hypothesis of this study is that using tissue adhesive rather than non absorbable sutures to reinforce forefoot wounds will reduce patient pain and anxiety at dressing change whilst not affecting the quality of wound healing. The study will be powered to assess these two parameters.
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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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Mr Andrew Wines
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Address
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North Sydney Orthopaedics and Sports Medicine Centre
Suite G02, Mater Clinic, 3 Gillies Street, Wollstonecraft NSW 2065, AUSTRALIA
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Country
105526
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Australia
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Phone
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+61 294090500
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Robbie Ray
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Address
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Princess Royal University Hospital, King's College Hospital NHS Foundation trust,
Farnborough Common,
Orpington,
BR6 8ND
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Country
105527
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United Kingdom
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Phone
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+441689 863000
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Fax
105527
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Email
105527
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[email protected]
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Contact person for scientific queries
Name
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Robbie Ray
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Address
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Princess Royal University Hospital, King's College Hospital NHS Foundation trust,
Farnborough Common,
Orpington,
BR6 8ND
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Country
105528
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United Kingdom
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Phone
105528
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+441689 863000
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Fax
105528
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Email
105528
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Patients were not consented for their individual participant data to be made available to others beyond this specific trial there
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
9211
Other
This study is being prepared for submission to a p...
[
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9212
Ethical approval
[email protected]
Please email if you would like a copy of the ethic...
[
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9213
Study protocol
[email protected]
Please email if you would like a copy of the study...
[
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9215
Informed consent form
[email protected]
Please email if you would like a copy of the patie...
[
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Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Randomized Controlled Trial of Topical Skin Adhesive vs Nylon Sutures for Incision Closure in Forefoot Surgery.
2021
https://dx.doi.org/10.1177/10711007211002501
N.B. These documents automatically identified may not have been verified by the study sponsor.
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