fixAtion of skiN Flaps After Mastectomy Using ruNning or Interrupted suturEs for Combatting Seroma (ANNIE)
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ClinicalTrials.gov Identifier: NCT05941351 |
Recruitment Status :
Not yet recruiting
First Posted : July 12, 2023
Last Update Posted : July 12, 2023
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Rationale: Flap fixation significantly reduces the incidence of seroma formation after mastectomy. Therefore, research should focus on finding the most optimal way to secure the skin flaps to the pectoral muscle. Previous studies have compared running sutures, interrupted sutures and tissue glue application to conventional wound closure. A recent systematic review with network meta-analysis indicated running sutures as the most optimal technique, however direct comparisons and high quality articles were lacking.
Objective: This prospective trial aims to directly compare running sutures with interrupted sutures in order to prevent complications in patients undergoing a mastectomy.
Study design: This trial will combine a retrospective cohort from the previous SARA-trial in Zuyderland MC with a randomised prospective trial. This study design was chosen to acquire a sample size with sufficient power and the ability to conduct this study in an acceptable time frame.
Study population: A retrospective cohort of patients participating in the SARA trial (RCT) and a prospective cohort of patients undergoing a mastectomy for breast cancer.
Intervention: Group 1: Flap fixation after mastectomy with running sutures. Group 2: Flap fixation after mastectomy with interrupted sutures.
Main study parameters/endpoints: The primary endpoint is the incidence of complications requiring interventions in both groups, including clinically significant seroma, infections and bleeding complications. Secondarily, the length of the procedure and cosmetic results will be compared.
Nature and extent of the burden and risks associated with participation, benefit and group relatedness: When participating, patients will undergo 3 additional outpatient clinic visits. Study visits will be combined with regular visits where possible, including the first postoperative visit after 7-10 days and either the 6 week or 3 month visit.
Condition or disease | Intervention/treatment | Phase |
---|---|---|
Seroma | Procedure: flap fixation | Not Applicable |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 361 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Prevention |
Official Title: | fixAtion of skiN Flaps After Mastectomy Using ruNning or Interrupted suturEs for Combatting Seroma |
Estimated Study Start Date : | January 1, 2025 |
Estimated Primary Completion Date : | January 1, 2027 |
Estimated Study Completion Date : | March 1, 2027 |
Arm | Intervention/treatment |
---|---|
Running
Group 1: Flap fixation after mastectomy with running sutures.
|
Procedure: flap fixation
flap fixation using running or interrupted sutures |
Individual
Group 2: Flap fixation after mastectomy with interrupted sutures.
|
Procedure: flap fixation
flap fixation using running or interrupted sutures |
- Complications requiring an intervention [ Time Frame: 3 months ]
The main study parameter is the incidence of complications requiring interventions in both groups. This consists of:
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Clinically significant seroma, requiring aspirations in the case of:
- Pain or discomfort for the patient caused by large amounts of seroma characterised by tenderness of the skin.
- Signs of infection (redness, swelling, pain).
- Signs of delayed wound healing (wound breakdown, necrosis, seroma leakage).
- Surgical site infections, requiring oral/iv antibiotics or surgical drainage.
- Bleeding complications, requiring re-intervention, aspiration or surgical debridement.
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- Surgery time [ Time Frame: during surgery ]surgery time in minutes
- Cosmetic outcome [ Time Frame: 3 months ]• Cosmetic results measured using a numeric rating score (NRS) from 0-10, in which 0 equals very dissatisfied with the cosmetic results and 10 equals very satisfied with the results.
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | Child, Adult, Older Adult |
Sexes Eligible for Study: | Female |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Female sex.
- 18 years or older.
- Indication for mastectomy.
Exclusion Criteria:
- Patients undergoing breast conserving therapy
- Patients undergoing direct breast reconstruction
- Patients undergoing modified radical mastectomy
- Unable to comprehend implications and extent of study and sign for informed consent
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05941351
Contact: Merel Spiekerman van Weezelenburg, MD | +31884597777 | m.spiekermanvanweezelenburg@zuyderland.nl |
Netherlands | |
Zuyderland MC | |
Sittard, Limbrug, Netherlands, 6162BG | |
Contact: Merel Spiekerman van Weezelenburg, MD +31884597777 m.spiekermanvanweezelenburg@zuyderland.nl |
Responsible Party: | Zuyderland Medisch Centrum |
ClinicalTrials.gov Identifier: | NCT05941351 |
Other Study ID Numbers: |
METCZ20230049 |
First Posted: | July 12, 2023 Key Record Dates |
Last Update Posted: | July 12, 2023 |
Last Verified: | June 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Seroma Inflammation Pathologic Processes |