Preoperative steroid in abdominal wall reconstruction: protocol for a randomised trial
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Preoperative steroid in abdominal wall reconstruction : protocol for a randomised trial. / Jensen, Kristian Kiim; Brøndum, Tina Lee; Belhage, Bo; Hensler, Margaret; Arnesen, Regnar Bøge; Kehlet, Henrik; Jørgensen, Lars Nannestad.
In: Danish Medical Journal, Vol. 63, No. 8, A5260, 08.2016.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Preoperative steroid in abdominal wall reconstruction
T2 - protocol for a randomised trial
AU - Jensen, Kristian Kiim
AU - Brøndum, Tina Lee
AU - Belhage, Bo
AU - Hensler, Margaret
AU - Arnesen, Regnar Bøge
AU - Kehlet, Henrik
AU - Jørgensen, Lars Nannestad
PY - 2016/8
Y1 - 2016/8
N2 - INTRODUCTION: Preoperative administration of high-dose glucocorticoid leads to improved recovery and decreased length of stay after abdominal surgery. Even so, studies on administration of glucocorticoids for patients undergoing abdominal wall reconstruction (AWR) for giant ventral hernia repair are lacking, perhaps due to a fear of impaired wound healing. We hypothesised that patients undergoing AWR would benefit from preoperative glucocorticoids and aimed at examining this in a randomised controlled trial.METHODS: A total of 40 patients scheduled to undergo AWR for ventral hernias with a fascial defect exceeding 10 cm will be randomised for intravenous administration of either 125 mg methylprednisolone or saline at the induction of anaesthesia. The primary endpoint is pain at rest on the first post-operative day. Patients will be followed until 30 days post-operatively, and secondary outcomes include subjective measures, wound complications and analysis of blood and wound fluids.CONCLUSIONS: This is the first trial on the effect of preoperative glucocorticoid administration in patients undergoing AWR. Due to long post-operative stays and a high rate of post-operative complications, this patient group can potentially benefit much from any post-operative optimisation. Furthermore, insight into any impact of glucocorticoids on wound healing in hernia patients may provide important information.FUNDING: none.TRIAL REGISTRATION: This study was registered with Clinicaltrials.gov (NCT02594241) and Eudra-CT (2015-004916-39).
AB - INTRODUCTION: Preoperative administration of high-dose glucocorticoid leads to improved recovery and decreased length of stay after abdominal surgery. Even so, studies on administration of glucocorticoids for patients undergoing abdominal wall reconstruction (AWR) for giant ventral hernia repair are lacking, perhaps due to a fear of impaired wound healing. We hypothesised that patients undergoing AWR would benefit from preoperative glucocorticoids and aimed at examining this in a randomised controlled trial.METHODS: A total of 40 patients scheduled to undergo AWR for ventral hernias with a fascial defect exceeding 10 cm will be randomised for intravenous administration of either 125 mg methylprednisolone or saline at the induction of anaesthesia. The primary endpoint is pain at rest on the first post-operative day. Patients will be followed until 30 days post-operatively, and secondary outcomes include subjective measures, wound complications and analysis of blood and wound fluids.CONCLUSIONS: This is the first trial on the effect of preoperative glucocorticoid administration in patients undergoing AWR. Due to long post-operative stays and a high rate of post-operative complications, this patient group can potentially benefit much from any post-operative optimisation. Furthermore, insight into any impact of glucocorticoids on wound healing in hernia patients may provide important information.FUNDING: none.TRIAL REGISTRATION: This study was registered with Clinicaltrials.gov (NCT02594241) and Eudra-CT (2015-004916-39).
KW - Abdominal Wall
KW - Abdominoplasty
KW - Adult
KW - Aged
KW - Dose-Response Relationship, Drug
KW - Double-Blind Method
KW - Female
KW - Follow-Up Studies
KW - Glucocorticoids
KW - Hernia, Ventral
KW - Herniorrhaphy
KW - Humans
KW - Injections, Intravenous
KW - Male
KW - Middle Aged
KW - Postoperative Complications
KW - Preoperative Care
KW - Surgical Mesh
KW - Treatment Outcome
KW - Wound Healing
KW - Journal Article
KW - Randomized Controlled Trial
M3 - Journal article
C2 - 27477797
VL - 63
JO - Danish Medical Journal
JF - Danish Medical Journal
SN - 2245-1919
IS - 8
M1 - A5260
ER -
ID: 176376837