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Effects of Compression in Mixed Ulcers (ULCEREMIXTE)

26 juillet 2016 mis à jour par: Groupe Hospitalier Paris Saint Joseph

About 15% to 30% of patients with venous leg ulcers have a peripheral arterial disease (PAD) associated. The compression band is still a controversial issue in this context. It allows the reduction of venous hypertension and edema, but it could potentially degrade the arterial infusion of high levels of compression. The French High Authority for Health (HAS) defines mixed ulcers by IPS between 0.5 and 0.9. Investigators distinguish mixed ulcers blood predominance for IPS between 0.5 and 0.7; and mixed ulcers predominantly venous blood with moderate involvement for IPS values between 0.7 and 0.9.

Several studies have shown that IPS> 0.8 allowed a high compression, between 30 and 40 mmHg. In the case of mixed ulcers with IPS between 0.6 and 0.8, the HAS recommends using a lighter compression, bit by elastic bands (exercising low power compression at rest) under medical supervision, informing the patient to remove the bandage if pain or aggravation. It is therefore necessary to adapt the compression therapy in case of venous ulcers associated with arterial disease by providing a lower compression 30 mmHg short stretch. For HAS, IPS <0.6 against indicates compression.

A recent study showed that compression bit elastic bands could not only improve venous return, but it would also increase the distal arterial flow in a patient population with mixed ulcers. In this study, 25 patients had between IPS 0.5 and 0.8; or for certain patients below the threshold of 0.6 indicates that against a compression according to HAS. To our knowledge this is the only study that has examined the effect of compression on blood perfusion.

Aperçu de l'étude

Statut

Complété

Les conditions

Intervention / Traitement

Description détaillée

Objectives:

  • Principal: Study the distal arterial infusion in a patient population with mixed ulcers under compression leg with little elastic bands
  • Secondary: To evaluate the safety of the little compression elastic band in a mixed population of patients with leg ulcers

Methodology :

  • Study non-interventional prospective single-center that evaluates professional practice from 25 patients with mixed leg ulcers and followed in the vascular medicine department of St. Joseph Hospital Group Paris.
  • Applying a bit compression elastic bandages to a pressure level between 30 and 40mmHg.
  • Anonymous data reports on the grid standardized collection, by a numbering system from 1 to 30 and then captured on a computer file

    • Age, risk factors and cardiovascular history of the patients,
    • Age, ulcer description
    • Palpation of pulse
    • morphological vascular profile of patients with arterial and venous Doppler dating less than a year,
    • Series following data before installation, 10 minutes after application and 24 hours after installation of the inelastic compression:

      o Evaluation of tolerance:

    • measurement of pain numeric scale (NS)
    • description of the skin condition of the leg by a dermatologist, seeking signs of suffering skin after application of compression: possible appearance of erythema, cyanosis, purpura. A search particularly in areas of bony prominences and the banks of the ulcer.

      o distal arterial pressures of the compression carrier leg:

    • IPS (systolic pressure index): ankle and arm pressures will be measured with a cuff and a continuous Doppler. GPI is calculated by dividing the lowest pressure at the ankle (at the dorsalis pedis or posterior tibial artery) by the humeral pressure.
    • Transcutaneous Oxygen Pressure (TcPO2) o Measuring pressure exerted by low elastic bandages by Kikuhime® system.

In case of bad tolerance of compression at any time after installation, the compression will be removed and the study stopped for the patient in question. Poor tolerance is defined by an increase in pain than or equal to 2 points on the digital scale.

expected benefits for patients:

  • Demonstration of good tolerance, defined as no worsening of the skin condition and the lack of increase in pain associated with inelastic compression.
  • Demonstration of no worsening of arterial infusion by inelastic compression.
  • Evidence of improved distal arterial hemodynamics (increased IPS and tcpO2) with a little elastic compression, which validate the results of the only study ever conducted on the subject.

Type d'étude

Observationnel

Inscription (Réel)

25

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

    • Ile-de-France
      • Paris, Ile-de-France, France, 75014
        • Groupe Hospitalier Paris Saint Joseph

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

Méthode d'échantillonnage

Échantillon non probabiliste

Population étudiée

Subjects older than 18 years, suffering from an ulcer of mixed origin leg, and followed in the vascular medicine department of St. Joseph Hospital Group Paris.

La description

The mixed origin of the ulcer is defined by a venous disease (reflux in the superficial veins and / or deep) and a moderate arterial disease, defined by:

Inclusion Criteria:

  • A IPS 0.5 and 0.9, with a systolic pressure at the ankle> 70 mmHg
  • A big toe pressure index (IPGO) <0.7, with a systolic pressure of the big toe (PGO)> 50 mmHg

Exclusion Criteria:

  • Topics aged under 18,
  • A normal IPS that is to say between 0.9 and 1.3, a critical ischemia (defined as ankle pressure <70 mmHg and / or systolic pressure of the big toe <50 mmHg)
  • Presence of peripheral neuropathy,
  • Presence of heart failure,
  • Refusal to participate in the study or to sign the consent,
  • Impaired cognitive function not to participate in a clinical study.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Délai
Assessment of change of pain numeric scale
Délai: Day 1, just before the exam, 10minutes after the exam and 24 hours after the exam
Day 1, just before the exam, 10minutes after the exam and 24 hours after the exam

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Assessment of change of distal arterial pressures of the compression carrier leg
Délai: Day 1, just before the exam, 10minutes after the exam and 24 hours after the exam
Day 1, just before the exam, 10minutes after the exam and 24 hours after the exam
Assessment of change of IPS (systolic pressure index) ankle pressures
Délai: Day 1, just before the exam, 10minutes after the exam and 24 hours after the exam
Day 1, just before the exam, 10minutes after the exam and 24 hours after the exam
Assessment of change of pressure exerted by low elastic bandage
Délai: Day 1, just before the exam, 10minutes after the exam and 24 hours after the exam
Measuring pressure exerted by low elastic bandages by Kikuhime® system.
Day 1, just before the exam, 10minutes after the exam and 24 hours after the exam
Assessment of IPS (systolic pressure index) arm pressures
Délai: Day 1, just before the exam, 10minutes after the exam and 24 hours after the exam
Day 1, just before the exam, 10minutes after the exam and 24 hours after the exam

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Les enquêteurs

  • Chercheur principal: STANSAL Audrey, MD, Groupe Hospitalier Paris Saint-Joseph (FRANCE)

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude

1 septembre 2015

Achèvement primaire (Réel)

1 juillet 2016

Achèvement de l'étude (Réel)

1 juillet 2016

Dates d'inscription aux études

Première soumission

13 juillet 2016

Première soumission répondant aux critères de contrôle qualité

19 juillet 2016

Première publication (Estimation)

20 juillet 2016

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Estimation)

27 juillet 2016

Dernière mise à jour soumise répondant aux critères de contrôle qualité

26 juillet 2016

Dernière vérification

1 juillet 2016

Plus d'information

Termes liés à cette étude

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • ULCERE MIXTE

Plan pour les données individuelles des participants (IPD)

Prévoyez-vous de partager les données individuelles des participants (DPI) ?

INDÉCIS

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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