Enhanced Sternal Closure With Montage or Montage-CT to Evaluate Post-Operative Opioid Use Following Median Sternotomy
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: Montage or Montage CT.
- Кому может быть актуально
- Состояния в реестре: Retrospective Review, Cerclage, Pain Management. Базовые параметры: 19 лет — 80 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- США
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Обзор
This is a retrospective study based on analysis real world data obtained from hospitals that have adopted use of Montage or Montage-CT for use following sternotomy. The analysis will report the post-operative use of analgesic medication (including opioids) and compare the use against a control group consisting of patients operated by the same surgeon concurrently or prior to adoption of Montage or Montage-CT for use in sternotomy closure.
Вмешательства
- Устройство Montage or Montage CT
Application of Montage or Montage-CT Settable Resorbable Bone Putty to the cut sternal edge at the time of closure.
Первичные конечные точки
- Cumulative Opiod Dose [Срок оценки: From admission until end of treatment/discharge, up to 8 weeks]
Вторичные конечные точки (4)
- Time to Discharge [Срок оценки: From admission until end of treatment/discharge, up to 8 weeks]
- Time to Opioid Cessation [Срок оценки: From admission until end of treatment/discharge, up to 8 weeks]
- Percent Discharged with Opioid Prescription [Срок оценки: From admission until end of treatment/discharge, up to 8 weeks]
- Percent without Opioid Use [Срок оценки: From admission until end of treatment/discharge, up to 8 weeks]
Критерии участия
Критерии включения
- Male or female > 19 years of age.
- Underwent non-emergent cardiac surgery (isolated coronary artery by-pass grafting and/or isolated valve surgery).
- Full median sternotomy approach - with/without cardiopulmonary bypass.
Критерии исключения
- Recent CPR.
- Previous cardiac surgery (redo sternotomy).
- Emergency surgery (operative intervention within 24 hrs of assessment).
- Chronic lung disease.
- BMI > 40.
- Use of sternal plate systems for closure.
- Recent antiplatelet therapy.
- Previous radiotherapy to the chest; receiving immunosuppressive therapy or have a current immunosuppressive condition.
- Active systemic infection (.i.e: endocarditis).
- Cognitive impairment (confusion, dementia, Alzheimers, current substance abuse).
- History of malignancies within past year (except squamous or basal cell carcinoma of the skin that has been treated; no recurrence)
- Recent history of drug or alcohol abuse.
- Females who are pregnant, nursing or of childbearing potential who are not practicing a birth control method with high reliability.
- Postsurgical life expectancy < 90 days in the opinion of the investigator.
14\. Moderate or severe pectus deformity. 16. Participation in another clinical trial. 17. Patients who had Patient-Controlled Analgesia (PCA) devices after surgery. 18. Patients who received a local anesthetic treatment and/or device on the sternum intraoperatively during surgery (e.g. On-Q Pain Relief System, Exparel etc)
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Модель наблюдения
- Случай-контроль
Центры проведения
США · 2 центра
- NCH Rooney Heart Institute — Naples
- Washington University — St Louis
Публикации
- Losanoff JE, Richman BW, Jones JW. Risk analysis of deep sternal wound infection and mediastinitis in cardiac surgery. Thorac Cardiovasc Surg. 2002 Dec;50(6):385. doi: 10.1055/s-2002-35738. No abstract available. PMID 12457323
- Meyerson J, Thelin S, Gordh T, Karlsten R. The incidence of chronic post-sternotomy pain after cardiac surgery--a prospective study. Acta Anaesthesiol Scand. 2001 Sep;45(8):940-4. doi: 10.1034/j.1399-6576.2001.450804.x. PMID 11576043
- Kalso E, Mennander S, Tasmuth T, Nilsson E. Chronic post-sternotomy pain. Acta Anaesthesiol Scand. 2001 Sep;45(8):935-9. doi: 10.1034/j.1399-6576.2001.450803.x. PMID 11576042
- Ingason AB, Geirsson A, Gudbjartsson T, Muehlschlegel JD, Sigurdsson MI. The Incidence of New Persistent Opioid Use Following Cardiac Surgery via Sternotomy. Ann Thorac Surg. 2022 Jan;113(1):33-40. doi: 10.1016/j.athoracsur.2021.04.030. Epub 2021 Apr 27. PMID 33930358
- Brown CR, Chen Z, Khurshan F, Groeneveld PW, Desai ND. Development of Persistent Opioid Use After Cardiac Surgery. JAMA Cardiol. 2020 Aug 1;5(8):889-896. doi: 10.1001/jamacardio.2020.1445. PMID 32584934
- Li AE, Fishman EK. Evaluation of complications after sternotomy using single- and multidetector CT with three-dimensional volume rendering. AJR Am J Roentgenol. 2003 Oct;181(4):1065-70. doi: 10.2214/ajr.181.4.1811065. No abstract available. PMID 14500232
- Losanoff JE, Jones JW, Richman BW. Primary closure of median sternotomy: techniques and principles. Cardiovasc Surg. 2002 Apr;10(2):102-10. doi: 10.1177/096721090201000203. PMID 11888737
- McGregor WE, Trumble DR, Magovern JA. Mechanical analysis of midline sternotomy wound closure. J Thorac Cardiovasc Surg. 1999 Jun;117(6):1144-50. doi: 10.1016/s0022-5223(99)70251-5. PMID 10343263
Идентификаторы
NCT: NCT07215546 · Abyrx PMRCT 25-002