Clinical trial NCT02213510: ZIPS Study - Zip Incision aPproximation vs. Suture
Official title: A Prospective, Non-blinded, Randomized Controlled Post-market Study Designed to Compare the Use of the Zip Surgical Skin Closure Device Versus Conventional Sutures for Skin Closure in Subjects Who Undergo a CIED Procedure.
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Wound
Cardiac Arrhythmia
Keywords: pacemaker
implantable cardioverter defibrillator
ICD
surgical wound closure
sutures
Zipline
Zips
CIED
cardiovascular implantable electronic devices
arrhythmia
Lead sponsor: University of California, San Diego
Sponsor class: OTHER
Collaborators: name: ZipLine Medical Inc.
First posted: 2014-08-11
Enrollment: 40
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL

Brief summary: ZipLine Medical, Inc. has developed a novel, non-invasive skin closure device called "Zip Surgical Skin Closure" to replace sutures, staples and glue for closure of the skin layer for surgical incisions or laceration repair. The study will be comparing the Zip Surgical Skin Closure to standard sutures in patients undergoing cardiovascular implantable electronic device (CIED) procedures on outcomes including closure time, cosmetic appearance of resulting scar, and overall cosmetic appearance of scar. The study will be following participants for 3 months following CIED procedure.

Detailed description: ZipLine Medical, Inc. has developed a novel, non-invasive skin closure device called "Zip Surgical Skin Closure" to replace sutures, staples and glue for closure of the skin layer for surgical incisions or laceration repair. The device is designed to provide closure speed superior to sutures, while resulting in a suture-like cosmetic outcome.The ZIPS study is a randomized, clinical trial comparing outcomes of procedures that use the Zip Surgical Skin Closure device with the outcomes of procedures that use stitches. The Zip Surgical Skin Closure is not an investigational device and is currently used in hospital across the United States. The Zip Surgical Skin Closure is a non-invasive (in other words, does not pierce the skin or enter into the wound) device to hold skin closed while healing can occur. It adheres to the skin close to the incision and uses adjustable straps to hold the incision closed. It is typically worn on the skin for 7-14 days and is removed by peeling from the skin. Patients will be randomized to either Zip Surgical Skin Closure or sutures, in addition to dissolvable sutures for the deeper layers, for surgical procedures for cardiovascular implantable electronic devices (CIED) i.e. pacemakers or defibrillators. Both of these closure techniques are considered standard of care at this facility and are not themselves experimental. However, the goal of this experimental study is to see if there are any significant differences between the two closure methods, in a controlled study environment.

Since the Zip Surgical Skin Closure device is relatively new to the market, there is a limited amount of information available describing the experience of patients and doctors using the device. In this study, the investigators will be looking to compare the Zip Surgical Skin Closure and stitches methods for the time necessary for the surgeon to close the incision, cosmetic appearance of the resulting scar, and satisfaction of you and your surgeon. The investigators will also be monitoring both study groups for occurrence of any adverse (unfavorable) events. Patients will be followed for a total of 3 months for this study. All study visits align with standard of care follow up for post-implantation of CIED. Non-identifiable pictures will be obtained of the scar during follow up and both patients and surgeons will complete questionnaires indicating their experience and satisfaction with the either skin closure method.

Eligibility criteria: Inclusion Criteria:

1. Patients 18 years of age and older;
2. Patients requiring suture closure for epidermal closure (after placement of cardiac implantable electronic devices; including de novo and re implant generator changes);
3. Patients willing and able to complete study protocol
4. Life expectancy greater than 1 year

Exclusion Criteria:

1. Known bleeding disorder not caused by medication;
2. Known personal or family history of keloid formation or scar hypertrophy;
3. Known allergy or hypersensitivity to non-latex skin adhesives;
4. Atrophic skin deemed clinically prone to blistering;
5. Any skin disorder affecting wound healing;
6. Any other condition that in the opinion of the investigator would make a particular subject unsuitable for this study.
7. Pregnancy

Primary outcomes:
measure: Overall Closure Time
timeFrame: 2 weeks
measure: Wound Healing as Determined by the CVAS (Cosmetic Visual Analogue Scale)
timeFrame: 3 Months
Secondary outcomes:
measure: Surgeon Wound Evaluation Scale (WES)
timeFrame: 2 weeks
measure: Surgeon Evaluation Based on the Wound Evaluation Scale (WES)
timeFrame: 3 Months
measure: Surgeon Satisfaction With Scar
timeFrame: 3 months
measure: Patient Comfort
timeFrame: 2 weeks
measure: Patient Satisfaction With Scar
timeFrame: 3 months
measure: Patient Rating of Scar
timeFrame: 3 months
measure: Patient Incision Pain
timeFrame: 1 day (discharge)
measure: Patient Incision Pain
timeFrame: 2 weeks
measure: Patient Incision Pain
timeFrame: 3 months
Other outcomes:
Locations:
city: La Jolla
country: United States
facility: UCSD Sulpizio Cardiovascular Center
state: California
Study officials:
affiliation: University of California, San Diego
name: Ulrika Birgersdotter-Green, MD
role: PRINCIPAL_INVESTIGATOR
References: