Trial Outcomes & Findings for Reducing INfection at the Surgical SitE With Antibiotic Irrigation During Ventral Hernia Repair (RINSE Trial) (NCT NCT03945357)

NCT ID: NCT03945357

Last Updated: 2023-08-24

Results Overview

Number of participants with Surgical Site Infections

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

250 participants

Primary outcome timeframe

30 days

Results posted on

2023-08-24

Participant Flow

Participant milestones

Participant milestones
Measure
Saline Irrigation
Normal saline is to be placed into the dissected retromuscular space AFTER placement and fixation of mesh. This should fill the cavity completely to the level of the skin. Irrigant is to be left to stand for a total of three minutes and then evacuated. Additional irrigation with saline PRIOR to the randomization is permitted at the surgeons' discretion for hemostasis with no requirement for duration. Additional saline irrigation of the subcutaneous space after fascia closure should be performed prior to skin closure. Normal saline: Comparison of saline solution rinse vs antibiotic rinse
Antibiotic Irrigation
Antibiotic solution is prepared consisting of 240 mg gentamicin and 600 mg clindamycin in 500 ml saline to ensure proper concentration. This solution should be placed into the dissected retromuscular space AFTER placement and fixation of mesh. This should fill the cavity completely to the level of the skin. Irrigant is to be left to stand for a total of three minutes and then evacuated. Additional irrigation with saline PRIOR to the randomization is permitted at the surgeons' discretion for hemostasis with no requirement for duration. Additional antibiotic irrigation of the subcutaneous space after fascia closure should be performed prior to skin closure. This second irrigation is not timed. Gemcitabine/ clindamycin: Comparison of saline solution rinse vs antibiotic rinse
Overall Study
STARTED
124
126
Overall Study
COMPLETED
121
120
Overall Study
NOT COMPLETED
3
6

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Saline Irrigation
n=124 Participants
Normal saline is to be placed into the dissected retromuscular space AFTER placement and fixation of mesh. This should fill the cavity completely to the level of the skin. Irrigant is to be left to stand for a total of three minutes and then evacuated. Additional irrigation with saline PRIOR to the randomization is permitted at the surgeons' discretion for hemostasis with no requirement for duration. Additional saline irrigation of the subcutaneous space after fascia closure should be performed prior to skin closure. Normal saline: Comparison of saline solution rinse vs antibiotic rinse
Antibiotic Irrigation
n=126 Participants
Antibiotic solution is prepared consisting of 240 mg gentamicin and 600 mg clindamycin in 500 ml saline to ensure proper concentration. This solution should be placed into the dissected retromuscular space AFTER placement and fixation of mesh. This should fill the cavity completely to the level of the skin. Irrigant is to be left to stand for a total of three minutes and then evacuated. Additional irrigation with saline PRIOR to the randomization is permitted at the surgeons' discretion for hemostasis with no requirement for duration. Additional antibiotic irrigation of the subcutaneous space after fascia closure should be performed prior to skin closure. This second irrigation is not timed. Gemcitabine/ clindamycin: Comparison of saline solution rinse vs antibiotic rinse
Total
n=250 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=124 Participants
0 Participants
n=126 Participants
0 Participants
n=250 Participants
Age, Categorical
Between 18 and 65 years
58 Participants
n=124 Participants
69 Participants
n=126 Participants
127 Participants
n=250 Participants
Age, Categorical
>=65 years
66 Participants
n=124 Participants
57 Participants
n=126 Participants
123 Participants
n=250 Participants
Sex: Female, Male
Female
74 Participants
n=124 Participants
61 Participants
n=126 Participants
135 Participants
n=250 Participants
Sex: Female, Male
Male
50 Participants
n=124 Participants
65 Participants
n=126 Participants
115 Participants
n=250 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.

PRIMARY outcome

Timeframe: 30 days

Population: 111 subjects in the saline group reached the 30 day visit. 110 subjects in the antibiotic group reached the 30 day visit.

Number of participants with Surgical Site Infections

Outcome measures

Outcome measures
Measure
Saline Irrigation
n=111 Participants
Normal saline is to be placed into the dissected retromuscular space AFTER placement and fixation of mesh. This should fill the cavity completely to the level of the skin. Irrigant is to be left to stand for a total of three minutes and then evacuated. Additional irrigation with saline PRIOR to the randomization is permitted at the surgeons' discretion for hemostasis with no requirement for duration. Additional saline irrigation of the subcutaneous space after fascia closure should be performed prior to skin closure. Normal saline: Comparison of saline solution rinse vs antibiotic rinse
Antibiotic Irrigation
n=110 Participants
Antibiotic solution is prepared consisting of 240 mg gentamicin and 600 mg clindamycin in 500 ml saline to ensure proper concentration. This solution should be placed into the dissected retromuscular space AFTER placement and fixation of mesh. This should fill the cavity completely to the level of the skin. Irrigant is to be left to stand for a total of three minutes and then evacuated. Additional irrigation with saline PRIOR to the randomization is permitted at the surgeons' discretion for hemostasis with no requirement for duration. Additional antibiotic irrigation of the subcutaneous space after fascia closure should be performed prior to skin closure. This second irrigation is not timed. Gemcitabine/ clindamycin: Comparison of saline solution rinse vs antibiotic rinse
Surgical Site Infection
11 Participants
10 Participants

SECONDARY outcome

Timeframe: 30 days

Population: 111 subjects in the saline group reached the 30 day visit. 110 subjects in the antibiotic group reached the 30 day visit.

Number of participants with SSI requiring reoperation or other procedural intervention at 30 days.

Outcome measures

Outcome measures
Measure
Saline Irrigation
n=111 Participants
Normal saline is to be placed into the dissected retromuscular space AFTER placement and fixation of mesh. This should fill the cavity completely to the level of the skin. Irrigant is to be left to stand for a total of three minutes and then evacuated. Additional irrigation with saline PRIOR to the randomization is permitted at the surgeons' discretion for hemostasis with no requirement for duration. Additional saline irrigation of the subcutaneous space after fascia closure should be performed prior to skin closure. Normal saline: Comparison of saline solution rinse vs antibiotic rinse
Antibiotic Irrigation
n=110 Participants
Antibiotic solution is prepared consisting of 240 mg gentamicin and 600 mg clindamycin in 500 ml saline to ensure proper concentration. This solution should be placed into the dissected retromuscular space AFTER placement and fixation of mesh. This should fill the cavity completely to the level of the skin. Irrigant is to be left to stand for a total of three minutes and then evacuated. Additional irrigation with saline PRIOR to the randomization is permitted at the surgeons' discretion for hemostasis with no requirement for duration. Additional antibiotic irrigation of the subcutaneous space after fascia closure should be performed prior to skin closure. This second irrigation is not timed. Gemcitabine/ clindamycin: Comparison of saline solution rinse vs antibiotic rinse
Incidence of SSI Requiring Intervention
8 Participants
8 Participants

Adverse Events

Saline Irrigation

Serious events: 9 serious events
Other events: 13 other events
Deaths: 1 deaths

Antibiotic Irrigation

Serious events: 5 serious events
Other events: 7 other events
Deaths: 3 deaths

Serious adverse events

Serious adverse events
Measure
Saline Irrigation
n=124 participants at risk
Normal saline is to be placed into the dissected retromuscular space AFTER placement and fixation of mesh. This should fill the cavity completely to the level of the skin. Irrigant is to be left to stand for a total of three minutes and then evacuated. Additional irrigation with saline PRIOR to the randomization is permitted at the surgeons' discretion for hemostasis with no requirement for duration. Additional saline irrigation of the subcutaneous space after fascia closure should be performed prior to skin closure. Normal saline: Comparison of saline solution rinse vs antibiotic rinse
Antibiotic Irrigation
n=126 participants at risk
Antibiotic solution is prepared consisting of 240 mg gentamicin and 600 mg clindamycin in 500 ml saline to ensure proper concentration. This solution should be placed into the dissected retromuscular space AFTER placement and fixation of mesh. This should fill the cavity completely to the level of the skin. Irrigant is to be left to stand for a total of three minutes and then evacuated. Additional irrigation with saline PRIOR to the randomization is permitted at the surgeons' discretion for hemostasis with no requirement for duration. Additional antibiotic irrigation of the subcutaneous space after fascia closure should be performed prior to skin closure. This second irrigation is not timed. Gemcitabine/ clindamycin: Comparison of saline solution rinse vs antibiotic rinse
Blood and lymphatic system disorders
Leukocytosis
0.81%
1/124 • 90 days
0.00%
0/126 • 90 days
Gastrointestinal disorders
bowel obstruction
0.81%
1/124 • 90 days
0.79%
1/126 • 90 days
Blood and lymphatic system disorders
hematoma
1.6%
2/124 • 90 days
0.00%
0/126 • 90 days
Respiratory, thoracic and mediastinal disorders
respiratory insufficiency
0.81%
1/124 • 90 days
2.4%
3/126 • 90 days
Respiratory, thoracic and mediastinal disorders
pneumonia
0.00%
0/124 • 90 days
0.79%
1/126 • 90 days
Injury, poisoning and procedural complications
alcohol withdrawal
0.81%
1/124 • 90 days
0.00%
0/126 • 90 days
Gastrointestinal disorders
ascites
0.81%
1/124 • 90 days
0.00%
0/126 • 90 days
Infections and infestations
wound infection
0.81%
1/124 • 90 days
0.00%
0/126 • 90 days
General disorders
lethargy
0.81%
1/124 • 90 days
0.00%
0/126 • 90 days

Other adverse events

Other adverse events
Measure
Saline Irrigation
n=124 participants at risk
Normal saline is to be placed into the dissected retromuscular space AFTER placement and fixation of mesh. This should fill the cavity completely to the level of the skin. Irrigant is to be left to stand for a total of three minutes and then evacuated. Additional irrigation with saline PRIOR to the randomization is permitted at the surgeons' discretion for hemostasis with no requirement for duration. Additional saline irrigation of the subcutaneous space after fascia closure should be performed prior to skin closure. Normal saline: Comparison of saline solution rinse vs antibiotic rinse
Antibiotic Irrigation
n=126 participants at risk
Antibiotic solution is prepared consisting of 240 mg gentamicin and 600 mg clindamycin in 500 ml saline to ensure proper concentration. This solution should be placed into the dissected retromuscular space AFTER placement and fixation of mesh. This should fill the cavity completely to the level of the skin. Irrigant is to be left to stand for a total of three minutes and then evacuated. Additional irrigation with saline PRIOR to the randomization is permitted at the surgeons' discretion for hemostasis with no requirement for duration. Additional antibiotic irrigation of the subcutaneous space after fascia closure should be performed prior to skin closure. This second irrigation is not timed. Gemcitabine/ clindamycin: Comparison of saline solution rinse vs antibiotic rinse
Gastrointestinal disorders
ileus
10.5%
13/124 • 90 days
5.6%
7/126 • 90 days

Additional Information

Aimee Hanvey

Prisma Health

Phone: 864-760-7350

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place