title: Preoperative steroid in abdominal wall reconstruction: protocol for a randomised trial.
abstract: BACKGROUND
  Preoperative administration of high-dose glucocorticoid leads to improved recovery and decreased length of stay after abdominal surgery. Even so, studies on administration of glucocorticoids for patients undergoing abdominal wall reconstruction (AWR) for giant ventral hernia repair are lacking, perhaps due to a fear of impaired wound healing. We hypothesised that patients undergoing AWR would benefit from preoperative glucocorticoids and aimed at examining this in a randomised controlled trial.
  
  
  METHODS
  A total of 40 patients scheduled to undergo AWR for ventral hernias with a fascial defect exceeding 10 cm will be randomised for intravenous administration of either 125 mg methylprednisolone or saline at the induction of anaesthesia. The primary endpoint is pain at rest on the first post-operative day. Patients will be followed until 30 days post-operatively, and secondary outcomes include subjective measures, wound complications and analysis of blood and wound fluids.
  
  
  CONCLUSIONS
  This is the first trial on the effect of preoperative glucocorticoid administration in patients undergoing AWR. Due to long post-operative stays and a high rate of post-operative complications, this patient group can potentially benefit much from any post-operative optimisation. Furthermore, insight into any impact of glucocorticoids on wound healing in hernia patients may provide important information.
  
  
  BACKGROUND
  none.
  
  
  BACKGROUND
  This study was registered with Clinicaltrials.gov (NCT02594241) and Eudra-CT (2015-004916-39).
authors.affiliation: mail@kristiankiim.dk.
authors.forename: Kristian Kiim
authors.initials: KK
authors.lastname: Jensen
authors.forename: Tina Lee
authors.initials: TL
authors.lastname: Brøndum
authors.forename: Bo
authors.initials: B
authors.lastname: Belhage
authors.forename: Margaret
authors.initials: M
authors.lastname: Hensler
authors.forename: Regnar Bøge
authors.initials: RB
authors.lastname: Arnesen
authors.forename: Henrik
authors.initials: H
authors.lastname: Kehlet
authors.forename: Lars Nannestad
authors.initials: LN
authors.lastname: Jørgensen
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D061645:Abdominoplasty / Q000379:methods*; D000328:Adult; D000368:Aged; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006555:Hernia, Ventral / Q000601:surgery; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*; D013526:Surgical Mesh; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
chemical_list: D005938:Glucocorticoids