COveRs to impRove AesthetiC ouTcome after Surgery for Chronic subdural haemAtoma by buRr hole trepanation (CORRECT-SCAR): protocol of a Swiss single-blinded, randomised controlled trial

Introduction Outcomes rated on impairment scales are satisfactory after burr hole trepanation for chronic subdural haematoma (cSDH). However, the surgery leads to bony defects in the skull with skin depressions above that are frequently considered aesthetically unsatisfactory by the patients. Those...

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Main Authors: Martin N Stienen, Kevin Akeret, Flavio Vasella, Julia Velz, Elisabeth Jehli, Pierre Scheffler, Stefanos Voglis, Oliver Bichsel, Nicolas Roydon Smoll, Oliver Bozinov, Luca Regli, Menno R Germans, David Bellut, Sandra F. Dias, Giuseppe Esposito, Jorn Fierstra, Dilek Könü-Leblebicioglu, Niklaus Krayenbühl, Marian C. Neidert, Markus Oertel, Carlo Serra, Lennart H. Stieglitz, Lazar Tosic, Laurenz Peltenburg-Brechneff, Basil E. Grüter, Anna-Sophie Hofer, Alexander Küffer, Philip-Rudolf Rauch, Martina Sebök, Bas van Niftrik, Tristan P. C. van Doormaal
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Language:English
Published: BMJ Publishing Group 2019-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/12/e031375.full
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author Martin N Stienen
Kevin Akeret
Flavio Vasella
Julia Velz
Elisabeth Jehli
Pierre Scheffler
Stefanos Voglis
Oliver Bichsel
Nicolas Roydon Smoll
Oliver Bozinov
Luca Regli
Menno R Germans
David Bellut
Sandra F. Dias
Giuseppe Esposito
Jorn Fierstra
Dilek Könü-Leblebicioglu
Niklaus Krayenbühl
Marian C. Neidert
Markus Oertel
Carlo Serra
Lennart H. Stieglitz
Lazar Tosic
Laurenz Peltenburg-Brechneff
Basil E. Grüter
Anna-Sophie Hofer
Alexander Küffer
Philip-Rudolf Rauch
Martina Sebök
Bas van Niftrik
Tristan P. C. van Doormaal
author_facet Martin N Stienen
Kevin Akeret
Flavio Vasella
Julia Velz
Elisabeth Jehli
Pierre Scheffler
Stefanos Voglis
Oliver Bichsel
Nicolas Roydon Smoll
Oliver Bozinov
Luca Regli
Menno R Germans
David Bellut
Sandra F. Dias
Giuseppe Esposito
Jorn Fierstra
Dilek Könü-Leblebicioglu
Niklaus Krayenbühl
Marian C. Neidert
Markus Oertel
Carlo Serra
Lennart H. Stieglitz
Lazar Tosic
Laurenz Peltenburg-Brechneff
Basil E. Grüter
Anna-Sophie Hofer
Alexander Küffer
Philip-Rudolf Rauch
Martina Sebök
Bas van Niftrik
Tristan P. C. van Doormaal
author_sort Martin N Stienen
collection DOAJ
description Introduction Outcomes rated on impairment scales are satisfactory after burr hole trepanation for chronic subdural haematoma (cSDH). However, the surgery leads to bony defects in the skull with skin depressions above that are frequently considered aesthetically unsatisfactory by the patients. Those defects could be covered by the approved medical devices (burr hole covers), but this is rarely done today. We wish to assess, whether the application of burr hole covers after trepanation for the evacuation of cSDH leads to higher patient satisfaction with the aesthetical result at 90 days postoperative, without worsening disability outcomes or increasing the complication rate.Methods and analysis This is a prospective, single-blinded, randomised, controlled, investigator-initiated clinical trial enrolling 80 adult patients with first-time unilateral or bilateral cSDH in Switzerland. The primary outcome is the difference in satisfaction with the aesthetic result of the scar, comparing patients allocated to the intervention (burr hole cover) and control (no burr hole cover) group, measured on the Aesthetic Numeric Analogue scale at 90 days postoperative. Secondary outcomes include differences in the rates of skin depression, complications, as well as neurological, disability and health-related quality of life outcomes until 12 months postoperative.Ethics and dissemination The institutional review board (Kantonale Ethikkommission Zürich) approved this study on 29 January 2019 under case number BASEC 2018–01180. This study determines, whether a relatively minor modification of a standard surgical procedure can improve patient satisfaction, without worsening functional outcomes or increasing the complication rate. The outcome corresponds to the value-based medicine approach of modern patient-centred medicine. Results will be published in peer-reviewed journals and electronic patient data will be safely stored for 15 years.Trial registration number NCT03755349.
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spelling doaj-art-c7942ad112144792bbd6a96ba5a3e3502024-12-03T10:25:18ZengBMJ Publishing GroupBMJ Open2044-60552019-12-0191210.1136/bmjopen-2019-031375COveRs to impRove AesthetiC ouTcome after Surgery for Chronic subdural haemAtoma by buRr hole trepanation (CORRECT-SCAR): protocol of a Swiss single-blinded, randomised controlled trialMartin N Stienen0Kevin Akeret1Flavio Vasella2Julia Velz3Elisabeth Jehli4Pierre Scheffler5Stefanos Voglis6Oliver Bichsel7Nicolas Roydon Smoll8Oliver Bozinov9Luca Regli10Menno R Germans11David BellutSandra F. DiasGiuseppe Esposito12Jorn Fierstra13Dilek Könü-LeblebiciogluNiklaus KrayenbühlMarian C. NeidertMarkus OertelCarlo SerraLennart H. StieglitzLazar Tosic14Laurenz Peltenburg-BrechneffBasil E. GrüterAnna-Sophie Hofer15Alexander KüfferPhilip-Rudolf RauchMartina SebökBas van NiftrikTristan P. C. van DoormaalDepartment of Neurosurgery, University Hospital Zurich, Clinical Neuroscience Center, University of Zurich, Zurich, SwitzerlandDepartment of Neurosurgery, University Hospital Zurich, Clinical Neuroscience Center, University of Zurich, Zurich, SwitzerlandDepartment of Neurosurgery, University Hospital Zurich, Clinical Neuroscience Center, University of Zurich, Zurich, Switzerland8 Clinical Neuroscience Center and Department of Neurosurgery, University Hospital and University of Zurich, Zurich, SwitzerlandDepartment of Neurosurgery, University Hospital Zurich, Clinical Neuroscience Center, University of Zurich, Zurich, SwitzerlandDepartment of Neurosurgery, University Hospital Zurich, Clinical Neuroscience Center, University of Zurich, Zurich, SwitzerlandDepartment of Neurosurgery, University Hospital Zurich, Zurich, SwitzerlandDepartment of Neurosurgery, University Hospital Zurich, Clinical Neuroscience Center, University of Zurich, Zurich, SwitzerlandSchool of Population and Global Health, University of Melbourne, Melbourne, Sydney, AustraliaDepartment of Neurosurgery, University Hospital Zurich, Clinical Neuroscience Center, University of Zurich, Zurich, Switzerland4Clinical Neuroscience Center and Department of Neurosurgery, University Hospital Zürich, University of Zürich, Zürich, SwitzerlandDepartment of Neurosurgery, University Hospital Zurich, Zurich, Switzerland3 Department of Radiology, Georgetown University, Washington, District of Columbia, USADepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, Zurich, SwitzerlandDepartment of Neurosurgery, University Hospital Zurich, Zurich, SwitzerlandDepartment of Neurosurgery, University Hospital Zurich, Zurich, SwitzerlandIntroduction Outcomes rated on impairment scales are satisfactory after burr hole trepanation for chronic subdural haematoma (cSDH). However, the surgery leads to bony defects in the skull with skin depressions above that are frequently considered aesthetically unsatisfactory by the patients. Those defects could be covered by the approved medical devices (burr hole covers), but this is rarely done today. We wish to assess, whether the application of burr hole covers after trepanation for the evacuation of cSDH leads to higher patient satisfaction with the aesthetical result at 90 days postoperative, without worsening disability outcomes or increasing the complication rate.Methods and analysis This is a prospective, single-blinded, randomised, controlled, investigator-initiated clinical trial enrolling 80 adult patients with first-time unilateral or bilateral cSDH in Switzerland. The primary outcome is the difference in satisfaction with the aesthetic result of the scar, comparing patients allocated to the intervention (burr hole cover) and control (no burr hole cover) group, measured on the Aesthetic Numeric Analogue scale at 90 days postoperative. Secondary outcomes include differences in the rates of skin depression, complications, as well as neurological, disability and health-related quality of life outcomes until 12 months postoperative.Ethics and dissemination The institutional review board (Kantonale Ethikkommission Zürich) approved this study on 29 January 2019 under case number BASEC 2018–01180. This study determines, whether a relatively minor modification of a standard surgical procedure can improve patient satisfaction, without worsening functional outcomes or increasing the complication rate. The outcome corresponds to the value-based medicine approach of modern patient-centred medicine. Results will be published in peer-reviewed journals and electronic patient data will be safely stored for 15 years.Trial registration number NCT03755349.https://bmjopen.bmj.com/content/9/12/e031375.full
spellingShingle Martin N Stienen
Kevin Akeret
Flavio Vasella
Julia Velz
Elisabeth Jehli
Pierre Scheffler
Stefanos Voglis
Oliver Bichsel
Nicolas Roydon Smoll
Oliver Bozinov
Luca Regli
Menno R Germans
David Bellut
Sandra F. Dias
Giuseppe Esposito
Jorn Fierstra
Dilek Könü-Leblebicioglu
Niklaus Krayenbühl
Marian C. Neidert
Markus Oertel
Carlo Serra
Lennart H. Stieglitz
Lazar Tosic
Laurenz Peltenburg-Brechneff
Basil E. Grüter
Anna-Sophie Hofer
Alexander Küffer
Philip-Rudolf Rauch
Martina Sebök
Bas van Niftrik
Tristan P. C. van Doormaal
COveRs to impRove AesthetiC ouTcome after Surgery for Chronic subdural haemAtoma by buRr hole trepanation (CORRECT-SCAR): protocol of a Swiss single-blinded, randomised controlled trial
BMJ Open
title COveRs to impRove AesthetiC ouTcome after Surgery for Chronic subdural haemAtoma by buRr hole trepanation (CORRECT-SCAR): protocol of a Swiss single-blinded, randomised controlled trial
title_full COveRs to impRove AesthetiC ouTcome after Surgery for Chronic subdural haemAtoma by buRr hole trepanation (CORRECT-SCAR): protocol of a Swiss single-blinded, randomised controlled trial
title_fullStr COveRs to impRove AesthetiC ouTcome after Surgery for Chronic subdural haemAtoma by buRr hole trepanation (CORRECT-SCAR): protocol of a Swiss single-blinded, randomised controlled trial
title_full_unstemmed COveRs to impRove AesthetiC ouTcome after Surgery for Chronic subdural haemAtoma by buRr hole trepanation (CORRECT-SCAR): protocol of a Swiss single-blinded, randomised controlled trial
title_short COveRs to impRove AesthetiC ouTcome after Surgery for Chronic subdural haemAtoma by buRr hole trepanation (CORRECT-SCAR): protocol of a Swiss single-blinded, randomised controlled trial
title_sort covers to improve aesthetic outcome after surgery for chronic subdural haematoma by burr hole trepanation correct scar protocol of a swiss single blinded randomised controlled trial
url https://bmjopen.bmj.com/content/9/12/e031375.full
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