- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04643223
Effect of Elastic Bandage With Tension on the Inflammatory Response of Hypertrophic Scars
Effect of Elastic Bandage With Tension on the Inflammatory Response of Hypertrophic Scars in Patients With Deep Burns: a Randomized Triple Blind Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Burns can lead to lesions of total thickness, which extend the reticular layer of the dermis requiring a repair process 1-2. This healing process, generally due to external and internal stimuli, causes scarring changes, among them, the hypertrophic scar 3-4. They develop about two months after the burn, occur more frequently in areas of high tension, preferably in the extensor faces of the joints or when they cross perpendicularly the lines of force of the skin. They exhibit scar tissue growth above the surface of the skin, respecting the limits of the original wound and are characterized by their reddish color, high stature, decreased flexibility and altered sensitivity 5-10. Patients with this type of scar can present stiffness in scar tissue, disfigurement, joint contractures, reduced range of motion, difficulties in daily functions and even psychological problems 11.
Mechanical strengths, when applied externally, can decrease the thickness of the epidermis, reduce the inflammatory response and promote a reorganization of the collagen fibers contained in the dermis, and thus improve the appearance of the vascularization and flexibility of the hypertrophic scar. Based on this principle, one of the therapeutic resources that can exert this external compressive effect is the elastic bandage - kinesio tape 12-13.
The use of elastic bandage - kinesio-taping is based on the principles of kinesiology and the self-healing ability of the organism. It takes advantage of the physical and mechanical properties of the bandage and the therapeutic action by the specific method of its application. Improving the appearance and perception of the scar, reducing functional limitations, thus repairing the patient's self-esteem 14-15.
Due to the few publications on the mechanism of action of elastic bandage, and its benefits, in the treatment of cicatricial sequelae due to burn. There was interest in seeking evidence that could support the mechanism of action of this therapeutic resource, and thus, a randomized, triple blind, controlled sham clinical trial was developed. It will be held at the Rehabilitation Center of the Governador Paulo Guerra Restoration Hospital (HR) located in Brazil and reference in the care of the burned patient. The study period will be from March 2018 to March 2020, with collection expected for June 2019 to November 2019.
The study population is the patients with hypertrophic scarring in the rehabilitation clinic of the HR. Patients will be picked up at the reception of this service, and they will be referred to the researcher responsible for the project. Once identified, the checklist of eligibility criteria and if eligible, patients will be invited by the researcher to participate in the study. In case of acceptance, the Informed Consent Form will be read aloud and if they agree to participate, they will sign it.
Those selected will be referred for initial clinical evaluation and other protocols that involve the study, among them, the selection of the scar, which will obey the inclusion criteria, and define the lesion treated with kinesio tape. In sequence, participants will be allocated randomly and stealthily through a computerized algorithm according to a table of sequential numbers from 1 to 30 using software R version 2.5.1. Generating the list of random allocation order, patients will use the letters A and B not knowing their meaning, being established only as treated with tension or without tension. Randomization is simple in two groups, the experimental or intervention group that will receive the kinesio tape with tension between seventy to ninety percent and the sham group with zero tension.
Patients will be referred for evaluation of the functional and aesthetic aspect of the hypertrophic scar, using as instrument of the Vancouver scale. In sequence will be taken to collect the scar material studied, through a biopsy performed at the Center for Treatment of Burns HR. After data collection, evaluation and biopsy, the treatment of patients is started. The therapeutic proposal will follow the routine of the service and the therapeutic protocol of the study common to all patients with cicatricial sequelae consisting of lubrication and massage of the scar and performing active free exercises and stretching for the limbs involved in the injury. It follows with the application of kinesio tape in the patients involved in the intervention and control groups.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Pernambuco
-
Recife, Pernambuco, Brazil
- Alex Sandro Roland de Souza
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Hypertrophic scars resulting from deep burns located in the upper and lower limbs and the anterior and posterior trunk;
Exclusion Criteria:
- Scar tissue showing scaling, somatosensory changes (touch, pressure and pain) and open wounds
- Pregnant women
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Kinesio tape with tension
The intervention group will receive the elastic bandage - kinesio tape with tension between seventy to ninety percent on the selected hypertrophic scar.
The application of kinesio tape follows a protocol, which involves the cleaning of the selected scar with liquid soap, drying, alcohol application for sebum removal, scar measurement and marking of the therapeutic zone and anchors.
Following the application of the kinesio tape, with tension between seventy to ninety percent on the treated hypertrophic scar.
This process follows the routine of patient care established by the service and will continue for a period corresponding to three months.
In which, the Vancouver assessments and collections of scarring material for the histopathology will be carried out, in the time intervals corresponding to the beginning of the study intervention / entry (time 0), 45 days and 90 days after being eligible, to agree to participate in the study study and intervention.
|
The application of kinesio tape follows a protocol, which involves the sanitization of the selected scar with liquid soap, drying and application of alcohol to remove sebum.
Measurement of the scar and marking of the therapeutic zone and anchors.
Following the application of kinesio tape, with tension between seventy to ninety percent on the treated hypertrophic scar.
This process follows the routine of patient care established by the service and will continue for a period corresponding to three months.
In which, the evaluations of Vancouver, the collections of cicatricial material will be carried out, in the time spaces corresponding to forty-five and ninety days, having as reference the initial evaluation made after being elected.
Other Names:
|
Sham Comparator: Kinesio tape without tension
The controlled sham group will receive the application of kinesio tape without tension will follow the same protocol above, including the three moments of evaluation, beginning of the intervention (time 0), 45 days and 90 days, after the beginning of the intervention.
|
The application of kinesio tape without tension follows a protocol, which involves the sanitization of the selected scar with liquid soap, drying and application of alcohol to remove sebum.
Measurement of the scar and marking of the therapeutic zone and anchors.
Following application of the kinesio tape, no tension on the treated hypertrophic scar.
This process follows the routine of patient care established by the service and will continue for a period corresponding to three months.
In which, the evaluations of Vancouver, the collections of cicatricial material will be carried out, in the time spaces corresponding to forty-five and ninety days, having as reference the initial evaluation made after being elected.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Histological pattern of the organization of the collagen fibers collected from the scar tissue (basal)
Time Frame: 0 day
|
the evaluations will only be carried out in a descriptive qualitative way, since the histology is characterized by analysis of the cells together with their cell matrix.
Thus the organization of the collagen fibers will be described as being distributed in parallel to the reticular layer of the dermis, or may also be described as randomly distributed to the reticular layer of the dermis.
Characterizing a variable of type yes/no.
|
0 day
|
Histological pattern of the organization of the collagen fibers collected from the scar tissue (45o. day)
Time Frame: 45 days
|
the evaluations will only be carried out in a descriptive qualitative way, since the histology is characterized by analysis of the cells together with their cell matrix.
Thus the organization of the collagen fibers will be described as being distributed in parallel to the reticular layer of the dermis, or may also be described as randomly distributed to the reticular layer of the dermis.
Characterizing a variable of type yes/no.
|
45 days
|
Histological pattern of the organization of the collagen fibers collected from the scar tissue (90o. day)
Time Frame: 90 days
|
the evaluations will only be carried out in a descriptive qualitative way, since the histology is characterized by analysis of the cells together with their cell matrix.
Thus the organization of the collagen fibers will be described as being distributed in parallel to the reticular layer of the dermis, or may also be described as randomly distributed to the reticular layer of the dermis.
Characterizing a variable of type yes/no.
|
90 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Inflammatory response through immunohistochemistry (basal)
Time Frame: 0 day
|
they correspond to the number of neutrophils, lymphocytes and mast cells that will be identified in the cicatricial tissue collected and analyzed quantitatively through the solft GRIMP 2.6.
Where the amount of pixels emitted will be based on the color reaction pixel: brown (neutrophil), yellow (lymphocyte) and blue (mast cell).
The program converts the pixel quantity of each color to a numerical value (n = Xμm).
The analysis will be performed by a professional from the Ageu Magalhães Institute of the Federal University of Pernambuco.
|
0 day
|
Inflammatory response through immunohistochemistry (45o. day)
Time Frame: 45 days
|
they correspond to the number of neutrophils, lymphocytes and mast cells that will be identified in the cicatricial tissue collected and analyzed quantitatively through the solft GRIMP 2.6.
Where the amount of pixels emitted will be based on the color reaction pixel: brown (neutrophil), yellow (lymphocyte) and blue (mast cell).
The program converts the pixel quantity of each color to a numerical value (n = Xμm).
The analysis will be performed by a professional from the Ageu Magalhães Institute of the Federal University of Pernambuco.
|
45 days
|
Inflammatory response through immunohistochemistry (90o. day)
Time Frame: 90 days
|
they correspond to the number of neutrophils, lymphocytes and mast cells that will be identified in the cicatricial tissue collected and analyzed quantitatively through the solft GRIMP 2.6.
Where the amount of pixels emitted will be based on the color reaction pixel: brown (neutrophil), yellow (lymphocyte) and blue (mast cell).
The program converts the pixel quantity of each color to a numerical value (n = Xμm).
The analysis will be performed by a professional from the Ageu Magalhães Institute of the Federal University of Pernambuco.
|
90 days
|
vancouver scale scars (basal)
Time Frame: 0 day
|
designed to evaluate the functional and aesthetic aspect of the scar.
It consists of items related to pigmentation, vascularity, flexibility and height of the scar; the final score ranges from 0 to 13, with the lowest score corresponding to the best result.
In the project in question will be used in the evaluation of the scar the items: vascularization, flexibility and height of the scar.
It will be applied by a trained professional familiar with the use of the scale, according to the intervals established for the other evaluation instruments (zero and sequential evaluation after 45 and 90 days).
This professional will evaluate and record the values corresponding to each of the scores mentioned below and in the end sum all the values generating a final score.
The data will go to an envelope that will be sealed and opened at the end of the data collection.
|
0 day
|
vancouver scale scars (45o. day)
Time Frame: 45 days
|
designed to evaluate the functional and aesthetic aspect of the scar.
It consists of items related to pigmentation, vascularity, flexibility and height of the scar; the final score ranges from 0 to 13, with the lowest score corresponding to the best result.
In the project in question will be used in the evaluation of the scar the items: vascularization, flexibility and height of the scar.
It will be applied by a trained professional familiar with the use of the scale, according to the intervals established for the other evaluation instruments (zero and sequential evaluation after 45 and 90 days).
This professional will evaluate and record the values corresponding to each of the scores mentioned below and in the end sum all the values generating a final score.
The data will go to an envelope that will be sealed and opened at the end of the data collection.
|
45 days
|
vancouver scale scars (90o. day)
Time Frame: 90 days
|
designed to evaluate the functional and aesthetic aspect of the scar.
It consists of items related to pigmentation, vascularity, flexibility and height of the scar; the final score ranges from 0 to 13, with the lowest score corresponding to the best result.
In the project in question will be used in the evaluation of the scar the items: vascularization, flexibility and height of the scar.
It will be applied by a trained professional familiar with the use of the scale, according to the intervals established for the other evaluation instruments (zero and sequential evaluation after 45 and 90 days).
This professional will evaluate and record the values corresponding to each of the scores mentioned below and in the end sum all the values generating a final score.
The data will go to an envelope that will be sealed and opened at the end of the data collection.
|
90 days
|
Collaborators and Investigators
Investigators
- Study Chair: Ana B Albuquerqu, master, Fernando Fiqueira IMI
- Study Chair: Cláudia F Lima, doctorate, Hospital da Restauração Governador Paulo Guerra - Hospital da Restauração
- Study Chair: Juliana N Maia, doctorate, Universidade Federal de Pernambuco - UFPE
- Study Chair: Edlene L Ribeiro, doctorate, Fundação Oswaldo Cruz - Instituto Aggeu Magalhães
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 (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- U1111-1231-9216
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
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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