Efficacy Study of Ultrasound-Assisted Debridement to Influence Wound Healing (UltraHeal)
A Randomized Controlled Trial to Investigate if Application of Low Frequency Ultrasound-assisted Debridement May Improve Healing and Infection Outcomes for the Person With Vasculopathy and Recalcitrant Wounds of the Lower Extremity
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Ontario
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Ottawa, Ontario, Canada, K1Y 4E9
- The Ottawa Hospital Wound Healing Centre
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Persons with lower extremity wound referred to vascular surgery service.
- Full thickness wound below the knee with surface area of at least 1cm2.
- Age >18 years
- English speaking
- Ulcer of known etiology including diabetic foot wounds, and arterial or venous leg ulcers
- Willing and able to adhere to 12 week study protocol that includes attending weekly clinic appointments, and wearing prescribed footwear or compression therapy
Exclusion Criteria:
- Leg wounds due to inflammatory conditions (e.g. pyoderma gangrenosum, vasculitis), malignancy, or other unknown etiologies.
- Severe arterial insufficiency: Absence of pedal pulses combined with Ankle Brachial Index ≤ 0.3, Toe Pressure ≤20, or Trans Cutaneous Oxygen Measure ≤20
- Presence of acute limb threatening infection
- Vascular surgery planned within next 3 months
- Exposed vascular graft or blood vessel, bone or tendon in the base of the wound.
- Currently receiving advanced wound therapy treatments: Hyperbaric therapy, biological dressings [collagen or extracellular matrix dressings].
- Increased likelihood of an adverse reaction to ultrasonic debridement due to:
- Excessive wound pain (>5 VAS scale) or patient described intolerable
- Allergy to topical anesthetic (lidocaine)
- Individuals who have factors/circumstances that are known to limit their ability to demonstrate healing in 4 weeks.
For example:
- medically unstable or palliative medical status
- poor nutritional status (low serum albumin < 15),
- anemia (Hb < 75 mg/dl),
- taking immunosuppressant medication (prednisone, chemotherapy; transplant anti-rejection medication),
- Individuals with medical conditions that contraindicate the use of ultrasound energy
- Cardiac pacemaker or defibrillator
- Excessive bleeding tendency (> 5 mins post debridement) or identified coagulopathic disorders
- Exposed bone in the wound base
- Untreated osteomyelitis
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: SINGLE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
EXPERIMENTAL: Ultrasound debridement
Participants receiving ultrasound assisted debridement in addition to best practice wound care.
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Ultrasound-assisted wound debridement with saline irrigant applied for 5 - 15 minutes until visible and removable non-viable appearance tissue is removed to reveal a healthy appearance wound bed.
Other Names:
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ACTIVE_COMPARATOR: Best Practice wound care
Participants receiving best practice wound care alone
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Participants will receive moist wound care with addition of silver alginate dressing for visual cues of infection.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in wound surface area
Time Frame: Weekly for 4 weeks then at 12 weeks.
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The wound surface area will be measured weekly once treatment is initiated, with a final measurement 12 weeks after initiation of therapy.
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Weekly for 4 weeks then at 12 weeks.
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Protease activity
Time Frame: Pre-treatment, post treatment at weeks 5 and weeks then at 12 weeks.
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A wound swab to test for elevated protease activity will be obtained before treatment and at week5 (after the 4 weekly treatments), and then again at week 12 to ascertain the immediate and sustained impact on inflammatory aspects of wound healing.
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Pre-treatment, post treatment at weeks 5 and weeks then at 12 weeks.
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Bacterial burden
Time Frame: Pre-treatment, week 5 and week 12
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A tissue culture to test for elevated bacterial activity and species identification will be obtained before treatment and at week 5 (after the 4 weekly treatments), and then again at week 12 to ascertain the immediate and sustained impact on infection aspects of wound healing
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Pre-treatment, week 5 and week 12
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Number of wounds healed
Time Frame: Throughout duration of the study
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We will count the number of wounds that have healed and have not healed for each group and compare to ascertain if the therapy improves healing.
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Throughout duration of the study
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Christine A. Murphy, MClSc PhD(c), The Ottawa Hospital
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 20130152-01H
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