Effects of Therapy With Sulfamylon® 5% Topical Solution Compared to a Historical Control Group

Prospective Evaluation of the Effects of Topical Therapy With Sulfamylon® For 5% Topical Solution on Autograft Healing in Subjects With Thermal Injuries Requiring Meshed Autografts: A Comparison to a Historical Control Group

The primary objective is to compare the effectiveness of treatment with Sulfamylon® solution as the initial topical moist dressing over meshed autografts following the initial graft procedure on preventing graft loss in a prospective cohort of subjects versus a historical control group in a non-inferiority trial.

Study Overview

• Status: Terminated
• Conditions: Burns
• Intervention / Treatment: Drug: Topical Antimicrobial/Antifungal Medications; Drug: Sulfamylon® For 5 % Topical Solution

Detailed Description

This is a prospective, non-inferiority, multi-center, historically controlled, open label study that will evaluate the effects of topical therapy with Sulfamylon® For 5% Topical Solution on autograft healing in subjects with thermal injuries requiring meshed autografts against a similar historic control population in which Sulfamylon® For 5% Topical Solution or mafenide acetate or other mafenide salt forms were not used. Prospective subjects meeting the entrance criteria will receive Sulfamylon® solution as topical antimicrobial treatment on moist dressings following initial meshed autograft procedure (Day 1). Sulfamylon® solution will be used every 6-8 hours, or as needed, to keep the dressing moist. The graft will be evaluated on Days 5-7, Days 12-14 and Days 18-21, unless the subject is discharged, dies, or experiences graft loss / regrafting of the initial meshed autograft prior to Assessment 4 (Days 18-21).

• Study Type: Interventional
• Enrollment (Actual): 220
• Phase: Phase 4

Contacts and Locations

Study Locations

• United States
  • Alabama
    • Mobile, Alabama, United States, 36617
      • University of South Alabama Medical Center
  • California
    • Redlands, California, United States, 92373
      • Arrowhead Regional Medical Center
  • Florida
    • Gainesville, Florida, United States, 32610
      • Shands Burn Center - Univ. of Florida
  • Illinois
    • Maywood, Illinois, United States, 60153
      • Loyola University Medical Center
    • Springfield, Illinois, United States, 62794-9653
      • The Plastic Surgery Institute - Southern Illinois Univ. School of Medicine
  • Kansas
    • Kansas City, Kansas, United States, 66160
      • University of Kansas Medical Center
  • Maryland
    • Baltimore, Maryland, United States, 21224
      • John's Hopkins Burn Center
  • Missouri
    • Columbia, Missouri, United States, 65212
      • University of Missouri Healthcare - Dept. of Surgery
  • North Carolina
    • Winston-Salem, North Carolina, United States, 27157
      • Wake Forest University - Department of General Surgery

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 1 year and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

In order for prospective subjects to be eligible for entry into the study:

• Subjects must have thermal injuries of 20-60% TBSA requiring at least one meshed autograft on the chest, abdomen, or proximal upper and lower extremities following surgical excision of the burn injury. Refer to Supplement 20.3.2: Lund Browder charts
• Subjects may be male or female, 3 months of age or older
• Females of childbearing potential must have a negative urine pregnancy test upon admission and agree to avoid pregnancy throughout the course of the study. Since this population is hospitalized for the duration of the study, an agreement of sexual abstinence is appropriate for this trial. Those subjects who do not wish to commit to sexual abstinence for the duration of this study must agree to avoid pregnancy by using a medically supervised method of contraception (such as hormonal contraception in conjunction with a vaginal spermicide or a tubal ligation at least 3 months prior to study entry)
• Subjects must be willing and able to provide written informed consent. If subjects are unable to provide written informed consent, then the subject's legally acceptable representative may provide written informed consent in accordance with the IRB/IEC, and federal, state and local regulations.

Exclusion Criteria:

Prospective subjects will be excluded from the study for the following reasons:

• Non-thermal burn injuries
• Inhalation injuries resulting in a PaO2 /FIO2 ratio < 300 mmHg on more than one arterial blood gas in the first 48 hours post-admission
• Females who are currently pregnant or breast feeding, or who intend to become pregnant during the course of the study
• Subjects with acute renal failure
• Subjects with known systemic allergy to sulfonamides or to sulfur-containing medication
• Time interval between burn injury and excision and grafting is greater than 7 days
• Grafting procedures that are conducted and/or evaluated on an outpatient basis
• Inability to use a meshed autograft as part of the initial grafting procedure
• Inability to use SS5% as the only initial prophylactic topical antimicrobial therapy on meshed autografts
• Thermal burn injuries less than 20% or greater than 60% TBSA
• Subjects who are participating in any other clinical studies involving any investigational product, or who have participated in such a study within the previous 30 days
• Subjects with known glucose-6-phosphate dehydrogenase deficiency

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Historical Control; Treated within the last 5 years (if possible) with topical prophylactic therapies that did not include mafenide acetate or mafenide salt forms. These are considered the Topical Antimicrobial/Antifungal Medications	Drug: Topical Antimicrobial/Antifungal Medications; 'Topical Antimicrobial/Antifungal Medications' Various topical antimicrobials and antifungals include: Bacitracin; Amphotericin B; Silver Sulfadiazine; Cefazolin; Vancomycin; Nystatin; Fluconazole; Piperacillin Sodium with Tazobactam.; Other Names: Bacitracin; Amphotericin B; others noted below.
Experimental: Prospective Patients/Active Drug; Prospective subjects with thermal injuries of 20-60% TBSA on the chest, abdomen, or proximal upper and lower extremities requiring meshed autografts on these areas will receive SS5% as the initial topical moist dressing over the meshed autograft(s) placed at the initial graft procedure (Day 1). Intervention is Sulfamylon® For 5 % Topical Solution.	Drug: Sulfamylon® For 5 % Topical Solution; Sulfamylon® For 5% Topical Solution is indicated for use as an adjunctive topical antimicrobial agent to control bacterial infection when used under moist dressings over meshed autografts on excised burn wounds.; Other Names: mafenide acetate

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Percentage of Participants With Graft Loss After Initial Meshed Autograft Procedure on Days 5-7.	The primary analysis will compare the percent of subjects with All Cause Graft Loss of the initial meshed autograft procedure at Days 5-7.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Percentage of Participants With All-cause Graft Loss at Days 12 to 14 in the FAS Population	All cause graft loss is defined as graft adhesion of < 85% for the initial meshed autograft procedure.	Secondary analyses will include the percent of subjects with All Cause Graft Loss at Days 12-14
Percentage of Participants With All-cause Graft Loss at Days 18 to 21 in the FAS Population	All cause graft loss is defined as graft adhesion of < 85% for the initial meshed autograft procedure.	Days 18 to 21
Percentage of Participants With Treatment Failure at Days 5 to 7 in the FAS Population	Treatment failure is defined as a change in topical antimicrobial therapy of initial meshed autograft due to suspected infection within the first 7 days or infectious graft loss.	Days 5-7
Percentage of Participants With Infectious Graft Loss at Days 5 to 7 in the FAS Population	Graft adhesion of < 85% for the initial meshed autograft procedure due to infection.	Days 5-7
Percentage of Participants With Infectious Graft Loss at Days 12 to 14 in the FAS Population	Graft adhesion of < 85% for the initial meshed autograft procedure due to infection.	Days 12-14
Percentage of Participants With Infectious Graft Loss at Days 18 to 21 in the FAS Population	Graft adhesion of < 85% for the initial meshed autograft procedure due to infection.	Days 18-21

Collaborators and Investigators

• Sponsor: Mylan Inc.
• Collaborators: Mylan Bertek Pharmaceuticals
• Investigators: Study Director: Eric Davis, MD, Mylan Inc.

Study record dates

Study Major Dates

• Study Start: September 1, 2007
• Primary Completion (Actual): December 1, 2013
• Study Completion (Actual): April 1, 2014

Study Registration Dates

• First Submitted: February 11, 2008
• First Submitted That Met QC Criteria: March 11, 2008
• First Posted (Estimate): March 12, 2008

Study Record Updates

• Last Update Posted (Actual): September 29, 2022
• Last Update Submitted That Met QC Criteria: September 14, 2022
• Last Verified: September 1, 2022

More Information

Terms related to this study

• Keywords: burns; thermal injuries; Burn Patients
• Additional Relevant MeSH Terms: Physiological Effects of Drugs; Molecular Mechanisms of Pharmacological Action; Anti-Infective Agents, Local; Enzyme Inhibitors; Hormones, Hormone Substitutes, and Hormone Antagonists; Carbonic Anhydrase Inhibitors; Cytochrome P-450 CYP3A Inhibitors; Cytochrome P-450 Enzyme Inhibitors; Hormone Antagonists; Steroid Synthesis Inhibitors; Antiprotozoal Agents; Antiparasitic Agents; Amebicides; 14-alpha Demethylase Inhibitors; Cytochrome P-450 CYP2C9 Inhibitors; Anti-Bacterial Agents; Antifungal Agents; Clotrimazole; Miconazole; Anti-Infective Agents; Amphotericin B; Bacitracin; Mafenide
• Other Study ID Numbers: SMS-401