Negative-Pressure Wound Therapy Versus Standard Treatment of Adult Patients With Conflict-Related Extremity Wounds: Protocol for a Randomized Controlled Trial

Andreas Älgå, Sidney Wong, Rawand Haweizy, Kalle Conneryd Lundgren, Johan von Schreeb, Jonas Malmstedt, Andreas Älgå, Sidney Wong, Rawand Haweizy, Kalle Conneryd Lundgren, Johan von Schreeb, Jonas Malmstedt

Abstract

Background: In armed conflict, injuries commonly affect the extremities and contamination with foreign material often increases the risk of infection. The use of negative-pressure wound therapy has been described in the treatment of acute conflict-related wounds, but reports are retrospective and with limited follow-up.

Objective: The objective of this study is to investigate the effectiveness and safety of negative-pressure wound therapy use in the treatment of patients with conflict-related extremity wounds.

Methods: This is a multisite, superiority, pragmatic randomized controlled trial. We are considering for inclusion patients 18 years of age and older who are presenting with a conflict-related extremity wound within 72 hours after injury. Patients are block randomly assigned to either negative-pressure wound therapy or standard treatment in a 1:1 ratio. The primary end point is wound closure by day 5. Secondary end points include length of stay, wound infection, sepsis, wound complications, death, and health-related quality of life. We will explore economic outcomes, including direct health care costs and cost effectiveness, in a substudy. Data are collected at baseline and at each dressing change, and participants are followed for up to 3 months. We will base the primary statistical analysis on intention-to-treat.

Results: The trial is ongoing. Patient enrollment started in June 2015. We expect to publish findings from the trial by the end of 2019.

Conclusions: To the best of our knowledge, there has been no randomized trial of negative-pressure wound therapy in this context. We expect that our findings will increase the knowledge to establish best-treatment strategies.

Trial registration: ClinicalTrials.gov NCT02444598; https://ichgcp.net/clinical-trials-registry/NCT02444598 (Archived by WebCite at http://www.webcitation.org/72hjI2XNX).

International registered report identifier (irrid): DERR1-10.2196/12334.

Keywords: extremity wounds; negative-pressure wound therapy; resource-limited settings; war-related injuries.

Conflict of interest statement

Conflicts of Interest: None declared.

©Andreas Älgå, Sidney Wong, Rawand Haweizy, Kalle Conneryd Lundgren, Johan von Schreeb, Jonas Malmstedt. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 26.11.2018.

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