Advancing Antimicrobial Photodynamic Therapy to Prevent Infection in Osseointegrated Prosthesis Patients
This will be a prospective observational trial enrolling 20 patients with osseointegrated prostheses. Participants will be recruited from the orthopaedic outpatient clinic at Walter Reed National Military Medical Center in Bethesda, MD.
All eligible consenting patients will undergo daily stoma management per standard of care.
Patients will integrate antimicrobial photodynamic therapy into their stoma management program. The first treatment will take place in the orthopaedic clinic. All others will take place at home. Topical 5-ALA will be applied to the metal at the penetration site. After 2 hours, the light delivery device will be utilized and light will be administered for 15 minutes.
Data collection: After obtaining informed consent, study personnel will record injury-specific variables, surgery-specific variables, other variables related to their hospital course, demographic variables as well as comorbidities on the study case report forms (CRFs). They will obtain this information directly from the participant, from the participant's medical record, and the participant's treating orthopaedic surgeon or other health care providers. Baseline data collection points include participant characteristics and amputation details such as age, sex, comorbidities, highest education level achieved, social support, initial reason for amputation, type of amputation and all surgical dates. Study participants will be followed at 1 and 2 weeks after initiation of PDT treatment. To ensure research participant safety, serious adverse events (SAEs) will be documented and promptly submitted to the local IRB as per the required reporting processes.
Follow-up: Study participants will be followed at 1 week and 2 weeks.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Devin Mullin
- Phone Number: 603-650-6032
- Email: Devin.S.Mullin@hitchcock.org
Study Contact Backup
- Name: Ida Gitajn
- Phone Number: 603-650-6032
- Email: Ida.Leah.Gitajn@hitchcock.org
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- All patients with osseointegrated prostheses 18 years of age or older
Exclusion Criteria:
- Ongoing infection
- Pregnant
- Anticipated issues with compliance or follow-up
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Osseointegration patients
All patients >18 years with osseointegrated prostheses.
|
All patients who are recruited and enrolled into this study use topical 5- ALA, in combination with the light delivery device as part of their standard stoma management.
All patients who are recruited and enrolled into this study use topical 5- ALA, in combination with the light delivery device photodynamic therapy device as part of their standard stoma management.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Feasibility
Time Frame: 2 weeks
|
Feasibility will be defined as 80% of patients successfully completing the administration protocol as well as 1 week/2-week follow-up.
|
2 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Treatment Evaluation Inventory-Short Form (TEI-SF)
Time Frame: 2 weeks
|
The TEI-sf is a 9-item questionnaire used to measure intervention acceptability from the participants point of view.
Scores range from 9 to 45, and scores above 27 are considered acceptable.
|
2 weeks
|
|
System Usability Scale (SUS)
Time Frame: 2 weeks
|
The SUS is a reliable 10-item usability measure with scores that range from 0 to 100 (an above average score is 68 or higher.
|
2 weeks
|
|
Bioburden quantification (16S rRNA sequencing)
Time Frame: 2 weeks
|
Bioburden will be quantified using quantitative PCR-based assays as well as addition of a "spikein" of a defined quantity of bacterial cells derived from halophilic organism Salnibacter ruber.
|
2 weeks
|
|
Bioburden quantification (Optical Coherence Tomography (OCT)
Time Frame: 2 weeks
|
Biofilm will be imaged and quantified on the metal abutment
|
2 weeks
|
|
OCT "virtual biopsy"
Time Frame: 2 weeks
|
Presence of inflammation, hypergranulation, and any resulting changes (e.g., the degree of epidermal regression, dermal attachment to the implant, and epithelial layer thickness) can be quantified through morphologic analysis of the OCT B-scans.
Scars are characterized by excessive collagen deposition, increased blood vessel density, and parallel blood vessel organization compared with normal skin.
|
2 weeks
|
|
Scar thickness
Time Frame: 2 weeks
|
Scar thickness measured using OCT
|
2 weeks
|
|
Blood vessel density
Time Frame: 2 weeks
|
Blood vessel density measuring using OCT
|
2 weeks
|
|
Presence of hypergranulation
Time Frame: 2 weeks
|
Hypergranulation measured using OCT
|
2 weeks
|
|
Pain during light exposure
Time Frame: 2 weeks
|
Patient reported pain during light exposure
|
2 weeks
|
|
Discomfort, burning, itchiness, or redness
Time Frame: 2 weeks
|
Patient reported discomfort, burning, itchiness or redness
|
2 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- STUDY02003108
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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