Hyperbaric Oxygen in Lower Leg Trauma

NCT ID: NCT00264511

Last Updated: 2023-09-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2/PHASE3

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-02-13

Study Completion Date

2016-03-23

Brief Summary

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Study hypothesis :Hyperbaric Oxygen may prevent complications and improve outcomes in severe lower limb trauma. We propose to investigate this hypothesis by conducting an International multi centre randomised control trial of standard trauma/orthopaedic care with or without a concurrent course of hyperbaric oxygen treatments.

Detailed Description

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A randomised controlled trial was undertaken on using hyperbaric oxygen in addition to standard orthopaedic trauma care in severe lower leg injury, defined as an open tibial fracture with severe soft tissue injury. The control arm subjects received standard hospital trauma care whilst the intervention group received standard trauma care with the addition of hyperbaric oxygen therapy with the aim of providing 12 HBOT sessions over the first 9 days of hospital care. The primary outcome measure was the incidence of wound necrosis AND/OR wound infection as assessed at Day 14, with secondary outcomes of wound closure, wound complications, infections and delayed bone union at 12 months plus quality of life and functional questionnaire outcomes at 12 months and 2 years.

The detailed study protocol was published in in June 2015 and the results were published in September 2022. Both publications are Open Access (See References section for publication details)

Conditions

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Tibial Fracture Soft Tissue Injury

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors
Surgeons initially operating were unaware of allocation. Outcomes arbitrations were conducted by surgeons blind to intervention allocation. Chief investigator masked until follow up data finally received and records locked.

Study Groups

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Hyperbaric oxygen treatment

Subjects in the HBO treatment group will receive a course of hyperbaric oxygen therapy (HBO) in addition to normal trauma and general care. A total of 12 HBO sessions will be delivered over approximately 8 days. HBO treatment will be provided at 2.4 atmospheres absolute (ATA) pressure for approximately 90 minutes of oxygen therapy. Treatments should be twice daily for the first three days. Minor variability will be allowed with respect to timing and profile of each session.

Group Type EXPERIMENTAL

Hyperbaric Oxygen Treatment

Intervention Type OTHER

Subjects in the HBO treatment group will receive a course of hyperbaric oxygen therapy (HBO) in addition to normal trauma and general care. A total of 12 HBO sessions will be delivered over approximately 8 days. HBO treatment will be provided at 2.4 atmospheres absolute (ATA) pressure for approximately 90 minutes of oxygen therapy. Treatments should be twice daily for the first three days. Minor variability will be allowed with respect to timing and profile of each session.

No hyperbaric oxygenation

Patients randomised to this group will receive standard trauma care.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Hyperbaric Oxygen Treatment

Subjects in the HBO treatment group will receive a course of hyperbaric oxygen therapy (HBO) in addition to normal trauma and general care. A total of 12 HBO sessions will be delivered over approximately 8 days. HBO treatment will be provided at 2.4 atmospheres absolute (ATA) pressure for approximately 90 minutes of oxygen therapy. Treatments should be twice daily for the first three days. Minor variability will be allowed with respect to timing and profile of each session.

Intervention Type OTHER

Other Intervention Names

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Hyperbaric oxygen therapy Hyperbaric Oxygen

Eligibility Criteria

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Inclusion Criteria

* Acute fracture of the tibia with significant soft tissue injury of Gustilo Grade 3
* Enrolment within 48 hours of injury with expectation of commencement of HBO therapy within 48 hours of injury
* Valid consent

Exclusion Criteria

* Significant head injury
* Injuries incompatible with HBO
* resuscitation requirements incompatible with HBO
* follow up not possible
* hyperbaric contra indications
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Monash University

OTHER

Sponsor Role collaborator

National Health and Medical Research Council, Australia

OTHER

Sponsor Role collaborator

Bayside Health

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ian L Millar, MBBS

Role: STUDY_CHAIR

Bayside Health

Owen Williamson

Role: PRINCIPAL_INVESTIGATOR

Monash University

Peter Cameron

Role: PRINCIPAL_INVESTIGATOR

Monash University

Locations

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John Muir Clinical Research Center

Concord, California, United States

Site Status

Royal Hobart Hospital

Hobart, Tasmania, Australia

Site Status

The Alfred

Melbourne, Victoria, Australia

Site Status

Universitatsklinikum Graz

Graz, , Austria

Site Status

Hospital del Trabajador

Santiago, , Chile

Site Status

City Hospital of Ostrava

Ostrava, , Czechia

Site Status

Indraprastha Apollo Hospital

New Delhi, Sarita Vihar, India

Site Status

Policlinico Umberto 1, University of Rome

Rome, , Italy

Site Status

Hospital Pedro Hispano

Senhora da Hora, Matosinhos, Portugal

Site Status

Karolinska Hospital

Stockholm, , Sweden

Site Status

Countries

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United States Australia Austria Chile Czechia India Italy Portugal Sweden

References

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Bouachour G, Cronier P, Gouello JP, Toulemonde JL, Talha A, Alquier P. Hyperbaric oxygen therapy in the management of crush injuries: a randomized double-blind placebo-controlled clinical trial. J Trauma. 1996 Aug;41(2):333-9. doi: 10.1097/00005373-199608000-00023.

Reference Type BACKGROUND
PMID: 8760546 (View on PubMed)

Garcia-Covarrubias L, McSwain NE Jr, Van Meter K, Bell RM. Adjuvant hyperbaric oxygen therapy in the management of crush injury and traumatic ischemia: an evidence-based approach. Am Surg. 2005 Feb;71(2):144-51.

Reference Type BACKGROUND
PMID: 16022014 (View on PubMed)

Millar IL, McGinnes RA, Williamson O, Lind F, Jansson KA, Hajek M, Smart D, Fernandes T, Miller R, Myles P, Cameron P. Hyperbaric Oxygen in Lower Limb Trauma (HOLLT); protocol for a randomised controlled trial. BMJ Open. 2015 Jun 11;5(6):e008381. doi: 10.1136/bmjopen-2015-008381.

Reference Type BACKGROUND
PMID: 26068515 (View on PubMed)

Millar IL, Lind FG, Jansson KA, Hajek M, Smart DR, Fernandes TD, McGinnes RA, Williamson OD, Miller RK, Martin CA, Gabbe BJ, Myles PS, Cameron PA; HOLLT investigator group. Hyperbaric Oxygen for Lower Limb Trauma (HOLLT): an international multi-centre randomised clinical trial. Diving Hyperb Med. 2022 Sep 30;52(3):164-174. doi: 10.28920/dhm52.3.164-174.

Reference Type BACKGROUND
PMID: 36100927 (View on PubMed)

Related Links

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Other Identifiers

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206/04

Identifier Type: -

Identifier Source: org_study_id

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