- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT00011531
Investigation of Subatmospheric Pressure Dressing on Pressure Ulcer Healing
Many spinal cord injury (SCI) and otherwise debilitated patients develop pressure ulcers over the course of their injury or disease. Despite enhanced wound care management, many pressure ulcers do not heal completely and require surgical myocutaneous rotational flap coverage. Even then they often recur.
The objectives of this study are: (1) to conduct a controlled comparative study of the effectiveness of subatmospheric pressure dressing (SPD) in healing pressure ulcers versus conventional saline wet-to-moist dressing techniques; (2) to establish indications and contra-indications for use of SPD In treating pressure ulcers; and (3) to develop a noninvasive, clinically usable optical digitizer and associated software for measurement of wound geometry for standardized quantitative assessment and longitudinal monitoring of wound healing.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Many spinal cord injury (SCI) and otherwise debilitated patients develop pressure ulcers over the course of their injury or disease. Despite enhanced wound care management, many pressure ulcers do not heal completely and require surgical myocutaneous rotational flap coverage. Even then they often recur.
HYPOTHESIS: Subatmospheric pressure dressing (SPD) treatment applied to pressure ulcers will either completely close them, or heal to a point allowing for skin graft coverage, more often than 0.9% normal saline wet-to-moist dressing (WTMD) treatment.
OBJECTIVES: The objectives of this study are: (1) to conduct a controlled comparative study of the effectiveness of subatmospheric pressure dressing (SPD) in healing pressure ulcers versus conventional saline wet-to-moist dressing techniques; (2) to establish indications and contra-indications for use of SPD In treating pressure ulcers; and (3) to develop a noninvasive, clinically usable optical digitizer and associated software for measurement of wound geometry for standardized quantitative assessment and longitudinal monitoring of wound healing.
RESEARCH METHODS: 120 patients with stage III or IV pressure ulcers meeting the project selection criteria will be recruited for the project. Patients will be randomly assigned in a 3:1 (SPD to WTMD) ratio to either the control group receiving 0.9% normal saline wet-to-moist wound dressing and treatment, or to the subatmospheric pressure dressing group. All subjects selected will be further stratified according to degree of wound severity, nutritional status, and evidence of wound infection. The WTMD group will receive 0.9% NS moistened gauze applied to the wound, which will be changed every 8 hours. The SPD group will receive SPD dressing with the VACTM system set at a constant subatmospheric pressure of negative 125 mmHg. The SPD device and dressing will be left in place and changed every Monday, Wednesday, and Friday. The subjects' pressure ulcers will be measured on day 0 and then on a weekly basis. Ulcer surface shape, area, and coloration will be recorded with a digital camera and also by tracing the ulcer perimeter on a flexible translucent plastic film with grid overlaid on the wound. In addition, an optical laser scanner will used to record ulcer shape, area, and coloration, and body/limb segmental volume in the region of the wound. Volume will also be measured using alginate wound impressions to form RTV silicone molds for fluid displacement measurement. The molds of the wounds will also be optically digitized and wound perimeter, topical surface area, total 3-D surface area, and volume calculated using computer image processing, planimetry, and volumetry software developed in the project. Local body/limb segment volume will also be calculated to monitor edematous fluctuations. Based on these measurements, the wound responses will be scored as described in Table 2 after one month or at the time of the patient's withdrawal from the study. The association between response level and treatment type will be analyzed using Chi-square test of association. Mantel-Haenszel Chi-square and logistic regression will be used to control for prognostic variables.
Type d'étude
Inscription (Anticipé)
Phase
- Phase 2
Contacts et emplacements
Lieux d'étude
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New York
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New York, New York, États-Unis, 10010
- New York Harbor HCS
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-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
Inclusion Criteria:
- Wounds and ulcers
Exclusion Criteria:
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
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Autre: 1
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Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Michael Longaker, MD, New York Harbor HCS
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
- Processus pathologiques
- Maladies cardiovasculaires
- Maladies vasculaires
- Maladies de la peau
- Maladies du système endocrinien
- Angiopathies diabétiques
- Ulcère de jambe
- Ulcère de la peau
- Complications du diabète
- Diabète sucré
- Neuropathies diabétiques
- Maladies du pied
- Pied diabétique
- Ulcère du pied
- Ulcère
- Ulcère de pression
Autres numéros d'identification d'étude
- B2108R
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