FALCON Trial Testing Measures to Reduce Surgical Site Infection

Last updated: September 24, 2019
Sponsor: University of Birmingham
Overall Status: Active - Recruiting

Phase

3

Condition

Abdominal Surgery

Treatment

N/A

Clinical Study ID

NCT03700749
RG_17-126
  • Ages < 100
  • All Genders

Study Summary

FALCON is a Pragmatic multi-centre trial testing measures to reduce superficial or deep skin infection following abdominal surgery in low and middle income countries. The trial will recruit patients undergoing abdominal surgery. Recruited participants will be randomly assigned to four arms to receive different combinations of skin preparation and sutures for would closure:

A. In this arm surgeon will use 2% alcoholic chlorhexidine for skin cleansing and non-coated suture for wound closure; B. In this arm surgeon will use 2% alcoholic chlorhexidine for skin cleansing and triclosan coated suture for wound closure; C. In this arm surgeon will use for operation 10% aqueous povidone-iodine for skin cleansing and non-coated suture for wound closure; D. In this arm surgeon will use 10% aqueous povidone-iodine for skin cleansing and triclosan-coated suture.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Patients with at least one abdominal incision that is ≥5cm (open or laparoscopicextraction site), with an anticipated clean-contaminated, contaminated or dirtysurgical wound.

  • Patients undergoing emergency (surgery on an unplanned admission) or elective (surgeryon a planned admission) operations.

  • Any operative indication, including trauma surgery.

  • Patient able and willing to provide written informed consent (signature or afingerprint).

  • Paediatric and adult patients. This criteria is made country-specific. Each countrydecides the lower age limit for the trial. This is dependent on country-specificregulatory approvals. Age eligibility will vary by country.

Exclusion

Exclusion Criteria:

  • Patients with a documented or suspected allergy to iodine, shellfish, or chlorhexidineskin preparation solution.

  • Patient unable to complete post-operative follow-up (i.e. will not be contactableafter discharge).

Study Design

Total Participants: 5480
Study Start date:
November 29, 2018
Estimated Completion Date:
July 31, 2021

Study Description

FALCON is a pragmatic, blinded (patient and outcome assessor), 2x2 factorial, stratified, multi-centre randomised controlled trial, with an internal pilot, to evaluate measures to reduce Surgical Site Infection (SSI) rates in patients undergoing surgery with an abdominal incision.

Surgical site infection (SSI) represents a major burden for patients, doctors, and health systems across all settings. SSI is the commonest postoperative complication worldwide and the commonest healthcare-associated infection in low and middle income countries (LMICs). SSIs cause pain, discomfort, disability, and increase the time taken to return to work (3). SSIs increase healthcare costs in all health settings. Whilst there is no direct data on the costs of SSI in LMICs, within the UK National Health Service, SSIs cost approximately £3500 per patient and £700 million per year in total. The impact of increased healthcare costs on patients, communities, and providers can be major in LMICs where personal income is low and patients may be required to pay for their own treatment. SSI has also been associated with one-third of postoperative deaths and accounts for 8% of all deaths caused by a hospital acquired infection.

Strata in FALCON trial are defined according to the anticipated category of wound contamination: (1) clean-contaminated and (2) contaminated/dirty. Eligible patients will be randomised at the level of the individual in a 1:1:1:1 ratio between:

A. 2% alcoholic chlorhexidine and non-coated suture B. 2% alcoholic chlorhexidine and triclosan-coated suture C. 10% aqueous povidone-iodine and non-coated suture D. 10% aqueous povidone-iodine and triclosan-coated suture.

Participant will be recruited from hospitals in Low and Middle Income Countries (LMICs). Participants who is undergoing abdominal surgery with an anticipated clean-contaminated, contaminated or dirty surgical wound will be selected to enter the trial.

The 6 month internal pilot will assess the feasibility of recruitment, compliance with treatment allocation and patient retention and follow-up rates. The main RCT will recruit 5480 participants.

Connect with a study center

  • Lagos University Teaching Hospital

    Lagos,
    Nigeria

    Active - Recruiting

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