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Trial registered on ANZCTR
Registration number
ACTRN12612001051831
Ethics application status
Approved
Date submitted
30/09/2012
Date registered
3/10/2012
Date last updated
14/03/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
Intranasal white petrolatum versus chlorhexidine to reduce postoperative infections in dermatologic surgery
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Scientific title
In patients scheduled for dermatologic surgery, is intranasal white petrolatum or chlorhexidine more effective than normal saline in reducing postoperative infections?
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Secondary ID [1]
281326
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Nil
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Universal Trial Number (UTN)
U1111-1135-3062
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Incidence of postoperative wound infections
287542
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Prevalance of staphylococcus aureus carriage
287543
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Skin Cancer
287561
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Condition category
Condition code
Surgery
287867
287867
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0
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Other surgery
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Cancer
287868
287868
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0
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Non melanoma skin cancer
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Infection
287869
287869
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0
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Studies of infection and infectious agents
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Referrals to the Skin Centre for excision of skin cancers will be selected for possible inclusion by one of five participating Consultant Dermatologists. Eligible and consenting patients will at the time of consultation for surgery, fill in a short questionnaire for demographic data and have a nasal swab to assess staphylococcus aureus carriage. The patients will be randomised to either intranasal white petrolatum, 2% chlorhexidine or normal saline to the anterior nares. Five days prior to elective surgery, all patients will apply one of three treatments (depending on randomisation) to the anterior nares twice daily. In the chlorhexidine arm and the normal saline arm, this will be in the manner of a soaked cotton bud whereas in the white petrolatum arm, this will be in the manner of a cotton bud application. All patients will have their wound assessed at the time of suture removal (expected range: 5 – 14 days depending on type of surgery) or if any clinical signs of wound infection occur outside this time frame (up to one month post-surgery). All infected wounds will be swabbed. The incidence of wound infection will be collected and a comparison will be made to the incidence of wound infection in patients being treated with intranasal white petrolatum, 2% chlorhexidine and individuals using intranasal normal saline.
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Intervention code [1]
285789
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Treatment: Other
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Intervention code [2]
285799
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Prevention
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Comparator / control treatment
Placebo - Normal saline in anterior nares twice daily for five days prior to elective surgery.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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To assess the efficacy of intranasal application of white petrolatum or chlorhexidine for reducing wound infections. The incidence of wound infections in the group using white petrolatum or chlorhexidine in the anterior nares (nostrils) will be compared to the incidence of wound infections in the group using normal saline.
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Assessment method [1]
288089
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Timepoint [1]
288089
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12 months after randomisation
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Secondary outcome [1]
299402
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To determine the prevalance of nasal carriage of staphylococcus aureus. The number of nasal swabs being positive (positive culture for growth) for staphylococcus aureus amongst the entire study population will be reported.
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Assessment method [1]
299402
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Timepoint [1]
299402
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12 months after randomisation
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Secondary outcome [2]
299403
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To determine which patients would benefit most from this approach if proven to be effective. A subgroup analysis would be performed to determine if there are any patient related factors (eg. Age, recent hospitalisation etc) which would place the patient at high risk for intranasal staphylococcus aureus carriage or high risk of post-operative wound infections.
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Assessment method [2]
299403
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Timepoint [2]
299403
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12 months after randomisation
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Secondary outcome [3]
299404
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To prove the cost-effectiveness of this method to reduce wound infections. The cost of intranasal white petrolatum and 2% chlorhexidine would be compared against the cost of managing post-operative wound infection.
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Assessment method [3]
299404
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Timepoint [3]
299404
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12 months after randomisation
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Eligibility
Key inclusion criteria
Patients scheduled for elective dermatologic surgery for removal of skin cancer.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Current infection
Current antibiotic therapy
Antibiotic use in the last month
Failure to have intranasal swab to assess carriage of S. aureus prior to surgery
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by computer. Each enrolled patient would be allocated a number and central randomisation by a computer program will be utilised.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation will be performed using block randomisation where patients will be allocated to treatment of intranasal white petrolatum or intranasal normal saline per surgeon per time.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
16/09/2013
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
2000
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
4578
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New Zealand
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State/province [1]
4578
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Bay of Plenty
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Funding & Sponsors
Funding source category [1]
286088
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Other Collaborative groups
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Name [1]
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Skin Cancer Institute
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Address [1]
286088
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171 Cameron Road
Tauranga 3110
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Country [1]
286088
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New Zealand
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Primary sponsor type
Individual
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Name
Eugene Tan
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Address
Skin Cancer Institute
171 Cameron Road
Tauranga 3110
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Country
New Zealand
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Secondary sponsor category [1]
284902
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Individual
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Name [1]
284902
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Paul Salmon
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Address [1]
284902
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Skin Cancer Institute
171 Cameron Road
Tauranga 3110
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Country [1]
284902
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New Zealand
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Other collaborator category [1]
277102
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Individual
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Name [1]
277102
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Neil Mortimer
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Address [1]
277102
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Skin Cancer Institute
171 Cameron Road
Tauranga 3110
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Country [1]
277102
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New Zealand
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Other collaborator category [2]
277112
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Hospital
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Name [2]
277112
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Associate Professor Marius Rademaker
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Address [2]
277112
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Waikato Hospital
Pembroke Street
Hamilton
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Country [2]
277112
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
288142
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Northern A Health and Disability Ethics Committee
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Ethics committee address [1]
288142
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Ministry of Health 1 the Terrace PO Box 5013 Wellington 6011 New Zealand
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Ethics committee country [1]
288142
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New Zealand
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Date submitted for ethics approval [1]
288142
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30/10/2012
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Approval date [1]
288142
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16/01/2013
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Ethics approval number [1]
288142
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12/NTA/79
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Summary
Brief summary
New Zealand has the highest rate of skin cancers in the world which leads to a large number of skin excisions. About 30-40% of the population carry a bacterium known as Staphylococcus aureus. Carriage of this bacterium has been shown to increase the risk of surgical wound infections by up to eight times. Earlier studies have assessed the effectiveness of a topical antibiotic, mupirocin to eradicate carriage of Staphylococcus aureus. Unfortunately, this method has been complicated by bacterial resistance and allergic skin reactions. In this study, we want to see whether applying white petrolatum (Vaseline) or Chlorhexidine is effective for eradicating nasal carriage of staphylococcus aureus and reducing wound infections in dermatologic surgery. If proven to be effective, this simple method may be a safe and economic method to reduce the incidence of wound infections in dermatologic surgery.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Eugene Tan
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Address
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Skin Cancer Institute
171 Cameron Road
Tauranga 3110
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Country
34778
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New Zealand
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Phone
34778
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+64-7-5785788
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Fax
34778
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Email
34778
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[email protected]
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Contact person for public queries
Name
18025
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Dr. Eugene Tan
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Address
18025
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171 Cameron Road
Tauranga 3110
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Country
18025
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New Zealand
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Phone
18025
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+64-7-5785788
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Fax
18025
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Email
18025
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[email protected]
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Contact person for scientific queries
Name
8953
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Dr. Eugene Tan
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Address
8953
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171 Cameron Road
Tauranga 3110
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Country
8953
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New Zealand
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Phone
8953
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+64-7-5785788
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Fax
8953
0
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Email
8953
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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