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用于手部无间隙创伤性感觉神经损伤一期修复的壳聚糖神经管:一项随机对照试验的研究方案

Chitosan nerve tube for primary repair of traumatic sensory nerve lesions of the hand without a gap: study protocol for a randomized controlled trial.

作者信息

Neubrech Florian, Heider Sina, Harhaus Leila, Bickert Berthold, Kneser Ulrich, Kremer Thomas

机构信息

Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic- and Hand Surgery, University of Heidelberg, Germany, Ludwig-Guttmann-Str. 13, D-67071, Ludwigshafen, Germany.

出版信息

Trials. 2016 Jan 26;17:48. doi: 10.1186/s13063-015-1148-5.

Abstract

BACKGROUND

Complex peripheral nerve injuries of the hand include at least 300,000 cases per year in Europe. The standard treatment involves a microsurgical end-to-end suture of traumatic sensory nerve lesions of the hand without a gap. The objective of this study protocol is to evaluate whether the additional use of a chitosan nerve tube in primary repair of traumatic sensory nerve lesions of the hand without a gap has an effect on the recovery of sensitivity.

METHODS/DESIGN: We planned a randomized double-blind controlled multicenter trial with a parallel group design in order to show superiority for the additional use of a chitosan nerve tube. This study will enroll 100 participants with traumatic sensory nerve lesions of the hand without a gap from three Trauma Care Centers. Participants will be randomized in a 1:1 ratio to primary microsurgical repair of the injured nerve with the additional use of a chitosan nerve tube or direct tension free microsurgical repair of the injured nerve alone. The static two-point discrimination of the injured finger after 6 months will be the primary outcome parameter.

DISCUSSION

In the proposed study, the additional use of a chitosan nerve tube for a primary microsurgical repair of traumatic sensory nerve lesions of the hand without a gap will be evaluated in a prospective randomized double-blind controlled multicenter trial for the first time to create the highest possible evidence for the procedure.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02372669 . Protocol Registration Receipt on 27 February 2015.

摘要

背景

在欧洲,每年手部复杂周围神经损伤病例至少有30万例。标准治疗方法是对手部无间隙的创伤性感觉神经损伤进行显微外科端端缝合。本研究方案的目的是评估在手部无间隙的创伤性感觉神经损伤的一期修复中额外使用壳聚糖神经管是否对感觉恢复有影响。

方法/设计:我们计划进行一项随机双盲对照多中心试验,采用平行组设计,以证明额外使用壳聚糖神经管的优越性。本研究将从三个创伤护理中心招募100名手部无间隙的创伤性感觉神经损伤患者。参与者将按1:1的比例随机分为两组,一组为在显微外科一期修复受损神经时额外使用壳聚糖神经管,另一组为仅进行无张力显微外科直接修复受损神经。6个月后受伤手指的静态两点辨别觉将作为主要结局参数。

讨论

在本拟议研究中,将首次在前瞻性随机双盲对照多中心试验中评估在手部无间隙的创伤性感觉神经损伤的一期显微外科修复中额外使用壳聚糖神经管,以为该手术创造尽可能高的证据水平。

试验注册

ClinicalTrials.gov标识符:NCT02372669。于2015年2月27日获得方案注册回执。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6d2/4727346/a8f5dd0b788b/13063_2015_1148_Fig1_HTML.jpg

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