Pan African Clinical Trials Registry

South African Medical Research Council, South African Cochrane Centre
PO Box 19070, Tygerberg, 7505, South Africa
Telephone: +27 21 938 0835 or +27 21 938 0967
Email: pactradmin@mrc.ac.za Website: pactr.samrc.ac.za
Trial no.: PACTR202203595456214 Date of Registration: 16/03/2022
Trial Status: Registered in accordance with WHO and ICMJE standards
TRIAL DESCRIPTION
Public title Caesarean Delivery Surgical Site Infection Product Trial:“The CDSSI Trial”
Official scientific title THE ROLE OF IRRISEPT IN REDUCING SURGICAL WOUND INFECTION FOLLOWING CAESAREAN SECTION IN FEDERAL MEDICAL CENTRE, YENAGOA SOUTH- SOUTH NIGERIA
Brief summary describing the background and objectives of the trial Primary Objective: To reduce CDSSI rates during the 30 days post delivery period when compared retrospectively to the CDSSI rate pre-trial. Secondary Objective: The secondary objectives will focus on measuring the reduced length of stay, actual costs associated with CDSSI, and extrapolated costs to the healthcare facility Caesarean deliveries are the most frequent surgical procedure performed in numerous countries and regions of the world.[1, 2] The infection risk associated with a caesarean delivery has been estimated to carry from 5 to 20-fold higher risk than for vaginal deliveries. Thus raising the maternal mortality and morbidity risk.[3] In a study by Koigi-Mamamu and colleagues, they reported surgical site infection rates as high as 20% in women having a caesarean delivery in Africa.[4] Across the African continent, the caesarean delivery surgical site infection (CDSSI) rate is reported to vary widely. CDSSIs prolong hospital stays, increases costs, and places a heavy burden on health care facilities that may have limited-resources available.[1, 5] In the Study by Brubaker et al of over 1.1 million caesarean deliveries, found a significant correlation associated in those “Women who did not labor were more likely to receive antibiotics than those who had a cesarean delivery after labor (66% compared with 44%, P<.001).”[3] In a quality improvement study by Mangold and colleagues in 2020, they used a commercially available and FDA-cleared irrigation solution containing 0.05% chlorhexidine gluconate in 99.95% sterile water to lavage the wounds of caesarean deliveries, focused on decreasing the CDSSI rate. What this study discovered was that the 0.05% chlorhexidine gluconate wound irrigation process helped protect the mother from a CDSSI when antibiotics were not given at the proper time.[6] Sub-Saharan African countries face a women’s health crisis associated with CDSSIs as the rate of caesarean deliveries increase.[7] With CDSSI and associated death rates.
Type of trial RCT
Acronym (If the trial has an acronym then please provide)
Disease(s) or condition(s) being studied Infections and Infestations,Pregnancy and Childbirth,Surgery
Sub-Disease(s) or condition(s) being studied Surgical Site Infection
Purpose of the trial Prevention
Anticipated trial start date 01/03/2022
Actual trial start date 01/04/2022
Anticipated date of last follow up 30/09/2022
Actual Last follow-up date 31/10/2022
Anticipated target sample size (number of participants) 200
Actual target sample size (number of participants) 200
Recruitment status Recruiting
Publication URL file:///C:/Users/Angela%20Unufe-Kennedy/Downloads/Mangold%20T%20%20et%20al.%20%20Standardizing%20intraoperative%20irrigation%20with%200.05%25%20in%20caesarean%20deivery%20to%20reduce%20surgical%20site%20infections%20(2).pdf
Secondary Ids Issuing authority/Trial register
STUDY DESIGN
Intervention assignment Allocation to intervention If randomised, describe how the allocation sequence was generated Describe how the allocation sequence/code was concealed from the person allocating the participants to the intervention arms Masking If masking / blinding was used
Factorial: participants randomly allocated to either no, one, some or all interventions simultaneously Randomised Simple randomization using a randomization table created by a computer software program Allocation was determined by the holder of the sequence who is situated off site Open-label(Masking Not Used)
INTERVENTIONS
Intervention type Intervention name Dose Duration Intervention description Group size Nature of control
Control Group Caesarean Delivery Surgical Site Infection Product Trial 1 The patient will be evaluated at discharge (3 – 5 days), 10 days and 30 days Caesarean sections will be carried out by consultants and senior registrars in the department. The intervention that will be used as the treatment (Group I) will be the irrigation of the incision with 0.05% chlorhexidine gluconate (CHG) in sterile water after repair of the rectus sheath. After allowing to stay for 60 seconds, the solution will then be suctioned out, and the incision will be irrigated with warm 0.9% sterile normal saline. Before application of 0.05% chlorhexidine gluconate, it will be warmed to a temperature of 40 °C. This is in accordance with the manufacturer's recommendations for use which recommend warming to no higher than 40 °C for up to seven days prior to use. The wound will be closed afterwards, and dressing applied. The control group (Group II) will receive the usual antibiotic regime used by the department for post-operative patients. Surgical site infections in the two groups will be compared. The patient will be evaluated at discharge (3 – 5 days), 10 days and 30 days 100 Active-Treatment of Control Group
Experimental Group Caesarean Delivery Surgical Site Infection Product Trial 1 bottle of 0.05% Chlorhexidine Gluconate (CHG) Following protocol, Duration is 60 seconds. Caesarean sections will be carried out by consultants and senior registrars in the department. The intervention that will be used as the treatment (Group I) will be the irrigation of the incision with 0.05% chlorhexidine gluconate (CHG) in sterile water after repair of the rectus sheath. After allowing to stay for 60 seconds, the solution will then be suctioned out, and the incision will be irrigated with warm 0.9% sterile normal saline. Before application of 0.05% chlorhexidine gluconate, it will be warmed to a temperature of 40 °C. This is in accordance with the manufacturer's recommendations for use which recommend warming to no higher than 40 °C for up to seven days prior to use. The wound will be closed afterwards, and dressing applied. The control group (Group II) will receive the usual antibiotic regime used by the department for post-operative patients. Surgical site infections in the two groups will be compared. The patient will be evaluated at discharge (3 – 5 days), 10 days and 30 days. 100
ELIGIBILITY CRITERIA
List inclusion criteria List exclusion criteria Age Category Minimum age Maximum age Gender
Pregnant women booked for elective Caesarean section. Unbooked patients Patients booked for emergency Caesarean section Obstructed labour Chorioamnionitis Patients being managed for any form of sepsis Adult: 18 Year(s)-44 Year(s) 18 Year(s) 50 Year(s) Female
ETHICS APPROVAL
Has the study received appropriate ethics committee approval Date the study will be submitted for approval Date of approval Name of the ethics committee
Yes 01/03/2022 Research Ethics Committee Federal Medical Centre Yenagoa
Ethics Committee Address
Street address City Postal code Country
Hospital Road, Ovom, Yenagoa, Bayelsa, Nigeria Yenagoa Yenagoa Nigeria
OUTCOMES
Type of outcome Outcome Timepoint(s) at which outcome measured
Primary Outcome To reduce CDSSI rates during the 30 days post delivery period when compared retrospectively to the CDSSI rate pre-trial 10 days
Secondary Outcome The secondary objectives will focus on measuring the reduced length of stay, actual costs associated with CDSSI, and extrapolated costs to the healthcare facility. 30 days.
RECRUITMENT CENTRES
Name of recruitment centre Street address City Postal code Country
Federal Medical Centre Hospital Hospital Road, Ovom, Yenagoa, Bayelsa, Nigeria Bayelsa Bayelsa, Nigeria
FUNDING SOURCES
Name of source Street address City Postal code Country
Infection Reduction Partners 626 Alderney Branch Lawrenceville GA 30044 United States of America
SPONSORS
Sponsor level Name Street address City Postal code Country Nature of sponsor
Primary Sponsor Infection Reduction Partners Atlanta USA Atlanta United States of America Charities/Societies/Foundation
COLLABORATORS
Name Street address City Postal code Country
Zenith Global Health SW9/1005 Adcoyo Road, off Ring Road, Ibadan, OYO, Nigeria Ibadan Nigeria
CONTACT PEOPLE
Role Name Email Phone Street address
Principal Investigator DENNIS OJU ALLAGOA dennisallagoa@yahoo.com +2348033103626 Federal Medical Centre Hospital Road, Ovom Yenagoa, Bayelsa, Nigeria
City Postal code Country Position/Affiliation
Bayelsa Nigeria Principal investigator
Role Name Email Phone Street address
Scientific Enquiries Sam Zaidspiner samz@InfectionReductionPartners.com 0014043179335 Atlanta
City Postal code Country Position/Affiliation
Atlanta United States of America CEO
Role Name Email Phone Street address
Public Enquiries Robert Byron Goodchild robertg@InfectionReductionPartners.com +447793547330 United Kingdom
City Postal code Country Position/Affiliation
London United Kingdom Director Partnerships Development
REPORTING
Share IPD Description Additional Document Types Sharing Time Frame Key Access Criteria
Yes Summary results of the trial will be made publicly available in a timely manner by posting to the results section of the clinical registry. In addition, if not available already available though a journal websites, the datasets on which research papers have published will be made available to any investigator. Informed Consent Form,Statistical Analysis Plan,Study Protocol within 24months of study completion Access to study reports and protocols will be open. Access to re-identified individual participate data will be available upon request from the study team
URL Results Available Results Summary Result Posting Date First Journal Publication Date
https://www.infectionreductionpartners.com/ No
Result Upload 1: Result Upload 2: Result Upload 3: Result Upload 4: Result Upload 5:
Result URL Hyperlinks Link To Protocol
Result URL Hyperlinks
Changes to trial information