- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02896725
Wool-derived Keratin Dressings for Venous Leg Ulcers (Keratin4VLU)
Keratin4VLU: A Randomised Controlled Trial of Wool-derived Keratin Dressings for Venous Leg Ulcers
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
A pragmatic, community based, single-blind, usual care-controlled, randomised trial to determine whether keratin dressings increase the proportion of patients with venous leg ulcers healed at 24 weeks when used in addition to compression in patients with slow healing venous leg ulcers. Participants in have compression therapy (system of choice guided by patient and/or clinical preference) as delivered through district nursing services at the study centres as a background treatment. Keratin dressings will be applied when the compression bandage is changed (approximately weekly). Usual care dressings will consist of the usual formulary of moist wound dressings available at each study centre.
Participants will be district nursing service patients in five study centres in New Zealand with prevalent or incident venous leg ulcers. A venous leg ulcer will be defined as a wound on the lower leg that has remained unhealed for 4 or more weeks, appears to be primarily venous in aetiology with other causative diseases ruled out. If the participant has two or more venous leg ulcers, the largest ulcer will be the reference ulcer. A participant will be considered to have a slow healing venous leg ulcer if the ulcer area is larger than 5 cm2 and/or the ulcer has been present for more than six months.
Participants will receive up to four visits from the research nurse - visit 1 to screen for eligibility, visit 2 to consent and randomise the participant, visits 3 and 4 to collect outcome data. District nurses will continue to visit the participant (about weekly or more frequently if required) to provide routine care between research nurse visits.
Block randomisation will be used, stratified by study centre and prognostic index (ulcer size greater than 5cm2 and/or ulcer duration greater than 6 months) to ensure a balance of participants within study centres and for participants likely to be slow healers. Research nurses will input information on inclusion criteria, exclusion criteria, and relevant clinical history on consented participants via a tablet computer. The allocation will be generated after this information has been entered. Randomised participants will receive the allocated treatment until the reference ulcer heals or data collection is completed, whichever occurs sooner.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Auckland, New Zealand
- University of Auckland
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Clinical indications of venous leg ulceration
- Ankle Brachial Index ≥ 0.7
- Able to tolerate compression therapy
- Ulcer area > 5cm2 and/or ulcer duration > 6 months
- Able to provide informed consent.
Exclusion Criteria:
- Hypersensitivity to wool or wool alcohols
- Venous leg ulceration with exposed tendon or bone
- Infected venous leg ulcer at trial inception (eligible after infection resolved)
- Venous leg ulcer with critical bioburden at trial inception (eligible if resolved)
- History of rheumatoid arthritis or vasculitis
- Uncontrolled diabetes
- Severe liver, heart, or renal failure
- Severe peripheral arterial disease
- Suspected or diagnosed skin malignancy
- Other threat to safe participation.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Keratin dressings
Wool-derived keratin matrix dressing applied with each change of the compression bandage until healing
|
Wool-derived keratin matrix dressings applied with each change of the compression bandage until healing or the trial ends
|
Active Comparator: Usual care dressings
Dressing chosen from study centres' formulary of non-medicated moist wound dressings applied with each change of the compression bandage until healing
|
Dressings chosen from study centres' formulary of non-medicated moist wound dressings (non-adherent dressings, hydrogel, alginate, hydrofibre or polyurethane foam dressings) applied with each change of the compression bandage until healing or the trial ends
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Proportion of patients with complete healing of reference ulcer
Time Frame: 24 weeks
|
24 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Agreement between blinded and unblinded assessors on healing
Time Frame: 24 week outcome
|
24 week outcome
|
|
Time to complete healing of reference ulcer
Time Frame: Until data collection completed two years after first participant is recruited
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Until data collection completed two years after first participant is recruited
|
|
Change in estimated reference ulcer area
Time Frame: 24 weeks
|
Estimated ulcer area will be derived measuring maximum width and length to determine area using formula for area of an ellipse.
Such an approach is highly co-related (r=0.92) with more sophisticated measurement methods.
|
24 weeks
|
Change in health-related quality of life (generic)
Time Frame: 24 weeks
|
The RAND-36 questionnaire will be used for measurement of generic health-related quality of life
|
24 weeks
|
Change in health-related quality of life (generic)
Time Frame: 24 weeks
|
The EuroQuol-5D questionnaire will be used to generate utility values for cost-effectiveness modelling should that be undertaken
|
24 weeks
|
Change in health-related quality of life (disease-specific)
Time Frame: 24 weeks
|
The Charing Cross Venous Ulcer Questionnaire will be used for measurement of disease-specific health-related quality of life
|
24 weeks
|
Incidence of adverse events
Time Frame: Until data collection completed two years after first participant is recruited
|
Until data collection completed two years after first participant is recruited
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Andrew Jull, RN PhD, National Institute for Health Innovation, University of Auckland
Publications and helpful links
General Publications
- Jull A, Wadham A, Bullen C, Parag V, Waters J. Wool-derived keratin dressings versus usual care dressings for treatment of slow-healing venous leg ulceration: study protocol for a randomised controlled trial (Keratin4VLU). BMJ Open. 2018 Feb 13;8(2):e020319. doi: 10.1136/bmjopen-2017-020319.
- Jull A, Wadham A, Bullen C, Parag V, Weller C, Waters J. Wool-derived keratin dressings versus usual care dressings for treatment of slow healing venous leg ulceration: a randomised controlled trial (Keratin4VLU). BMJ Open. 2020 Jul 20;10(7):e036476. doi: 10.1136/bmjopen-2019-036476.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- Keratin4VLU
- U1111-1186-5202 (Other Identifier: World Health Organisation Universal Trial Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
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.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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