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Premature termination due to cease of funding
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| Name | Class |
|---|---|
| Integra LifeSciences Corporation | INDUSTRY |
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The purpose of this study is to assess the incidence of hernia recurrence with the use of biologic and prosthetic mesh in ventral hernia repair.
Incisional hernias are very common, leading to over 380,000 operative repairs done annually. Despite the commonality of this problem, there has been no single operative repair that has become the standard. This is due to the high recurrence rates with all types of repairs, especially primary suture repair. Because of this, most repairs are done with some type of mesh, either made out of a prosthetic material or biologic material. Mesh repairs, however, have their own problems, namely surgical site infections and potential bowel erosion. Potential complications associated with prosthetic mesh for hernia repairs include: adverse reactions to the mesh, mesh erosion, stricture formation, adhesions resulting in bowel obstruction, enterocutaneous fistulas, injuries to nearby organs, nerves or blood vessels, infection, chronic pain and hernia recurrence. Potential complications associated with biological mesh include: adverse inflammatory response, laxity, eventration, and recurrent herniation. To address these mesh related complications, the separation of components technique was developed to reduce tension on the midline repair and the underlay technique was developed to place the mesh in the retrorectus space. Nevertheless, this technique still has a significant recurrence rate.
Therefore, the purpose of this study is to evaluate the effectiveness of biological or prosthetic mesh in incisional hernia repair, by assessing the associated rates of hernia recurrence and complications.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard of care | Mesh for hernia repair: Standard of care products used by the Investigator for open ventral hernia repair procedure |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mesh for hernia repair | Device | Permacol, Parietex, Progrip, Strattice Perforated, and Surgimend. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of ventral hernia recurrence | 2 years from study ventral hernia repair |
| Measure | Description | Time Frame |
|---|---|---|
| Time to ventral hernia recurrence | 2 years from study ventral hernia repair | |
| Incidence of wound complications | Complications of interest: surgical site infections, seroma formation, and wound dehiscence or skin separation |
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Inclusion Criteria:
Exclusion Criteria:
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Patients requiring open ventral hernia repair.
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| Name | Affiliation | Role |
|---|---|---|
| Vic Velanovich, MD | University of South Florida | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tampa General Hospital | Tampa | Florida | 33606 | United States | ||
| University of South Florida - South Tampa Campus |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25222715 | Background | Fekkes JF, Velanovich V. Amelioration of the effects of obesity on short-term postoperative complications of laparoscopic and open ventral hernia repair. Surg Laparosc Endosc Percutan Tech. 2015 Apr;25(2):151-7. doi: 10.1097/SLE.0000000000000100. | |
| 21904861 | Background | Poulose BK, Shelton J, Phillips S, Moore D, Nealon W, Penson D, Beck W, Holzman MD. Epidemiology and cost of ventral hernia repair: making the case for hernia research. Hernia. 2012 Apr;16(2):179-83. doi: 10.1007/s10029-011-0879-9. Epub 2011 Sep 9. |
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| ID | Term |
|---|---|
| D059685 | Herniorrhaphy |
| ID | Term |
|---|---|
| D019651 | Plastic Surgery Procedures |
| D013514 | Surgical Procedures, Operative |
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| 90 days from study ventral hernia repair |
| Incidence of enterocutaneous fistula formation | 2 years from study ventral hernia repair |
| Mean Carolinas Comfort Scale score | Patient-centered outcome assessing hernia symptoms - minimum score 0 and maximum total score 115 | 2 years from study ventral hernia repair |
| Mean Visual Analog Scale score | Patient-centered outcome - pain score measured by a line in millimeters (0 for no pain and 10 for worst pain imaginable) | 2 years from study ventral hernia repair |
| Mean mesh deployment time | Defined as the time mesh preparation starts to time mesh placement ends | during surgery |
| Mean procedure time | Defined as time of incision to time of closure | during surgery |
| Mean total cost of hospitalization for primary admission | Defined as cost from surgery to hospital discharge | From date of surgery to date of hospital discharge (approximately 3 days) |
| Mean total cost of surgery for primary admission | Defined as cost from preoperative preparation to anesthesia discharge | during surgery |
| Mean total cost of narcotic usage for primary admission | Defined as cost from narcotic use from surgery to hospital discharge | From date of surgery to date of hospital discharge (approximately 3 days) |
| Mean total cost of readmissions | any hospital readmissions related to ventral hernia complications or recurrence | 2 years from study ventral hernia repair |
| Tampa |
| Florida |
| 33606 |
| United States |
| University of South Florida Morsani Center for Advanced Health Care | Tampa | Florida | 33612 | United States |
| 25472771 | Background | Fischer JP, Wink JD, Tuggle CT, Nelson JA, Kovach SJ. Wound risk assessment in ventral hernia repair: generation and internal validation of a risk stratification system using the ACS-NSQIP. Hernia. 2015 Feb;19(1):103-11. doi: 10.1007/s10029-014-1318-5. Epub 2014 Dec 4. |
| 9382393 | Background | Zhou XH, Melfi CA, Hui SL. Methods for comparison of cost data. Ann Intern Med. 1997 Oct 15;127(8 Pt 2):752-6. doi: 10.7326/0003-4819-127-8_part_2-199710151-00063. |
| 26206646 | Result | Holihan JL, Alawadi Z, Martindale RG, Roth JS, Wray CJ, Ko TC, Kao LS, Liang MK. Adverse Events after Ventral Hernia Repair: The Vicious Cycle of Complications. J Am Coll Surg. 2015 Aug;221(2):478-85. doi: 10.1016/j.jamcollsurg.2015.04.026. Epub 2015 May 9. |
| 18387468 | Result | Heniford BT, Walters AL, Lincourt AE, Novitsky YW, Hope WW, Kercher KW. Comparison of generic versus specific quality-of-life scales for mesh hernia repairs. J Am Coll Surg. 2008 Apr;206(4):638-44. doi: 10.1016/j.jamcollsurg.2007.11.025. Epub 2008 Feb 1. |
| 24166693 | Result | Nielsen K, Poelman MM, den Bakker FM, van der Ploeg T, Bonjer HJ, Schreurs WH. Comparison of the Dutch and English versions of the Carolinas Comfort Scale: a specific quality-of-life questionnaire for abdominal hernia repairs with mesh. Hernia. 2014 Aug;18(4):459-64. doi: 10.1007/s10029-013-1173-9. Epub 2013 Oct 29. |
| 26106284 | Result | FitzGerald JF, Kumar AS. Biologic versus Synthetic Mesh Reinforcement: What are the Pros and Cons? Clin Colon Rectal Surg. 2014 Dec;27(4):140-8. doi: 10.1055/s-0034-1394155. |
| 2642367 | Result | Aravot DJ, Banner NR, Khaghani A, Fitzgerald M, Radley-Smith R, Mitchell AG, Yacoub MH. Cardiac transplantation in the seventh decade of life. Am J Cardiol. 1989 Jan 1;63(1):90-3. doi: 10.1016/0002-9149(89)91082-5. |