A Comparison of an Investigational Dressing to Tegaderm Matrix Wound Dressing in the Management of Diabetic Foot Ulcers

NCT ID: NCT01013792

Last Updated: 2024-10-02

Study Results

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-11-30

Study Completion Date

2012-07-31

Brief Summary

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The primary objective is to:

* Assess the effect of the Non-adherent study dressing to 3M Tegaderm Matrix Dressing with PHI technology on wound healing in patients with a diabetic foot ulcer.

Secondary objectives are to:

* Assess the adverse events that occur in subjects randomized to the investigational dressing in comparison to subjects randomized to the Tegaderm Matrix Dressing with PHI technology.
* Assess the costs of using the investigational dressing compared to the Tegaderm Matrix Dressing with PHI technology.
* Assess and compare the impact that these dressings have on patients' quality of life.
* Assess the wound's biological response and pH to the study dressings.

Detailed Description

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The primary objective of this study is to compare the effect of an investigational, non-adherent dressing to a commercial wound dressing, 3M™ Tegaderm™ Matrix Dressing with PHI™ technology (Matrix dressing), in the management of diabetic foot ulcers. Subjects' wounds will be observed for a four week, pre-treatment period with wound assessments being made and samples of wound fluid and tissue collected and analyzed to characterize the wound. Following this pre-treatment observational stage, subjects continuing to meet inclusion/exclusion criteria will be randomly assigned, with stratification by center, wound size and wound duration, in either of two groups in the eight week treatment stage of the study. Subjects in one group will have their wound managed with an investigational non-adherent dressing, and subjects in the other group will have their wound managed with a Matrix dressing. At Visit 4 (start of the treatment stage of the study), subjects with a study wound that is less than 1 cm2 at this point will be dropped from the study. A second investigational device will be used to measure the pH of the wound, which will be compared to wound healing data.

Pre-treatment Stage Secondary Objectives

1. To measure and compare changes in wound size and wound assessments with changes in wound biomarker levels, wound pH, microbial load, and changes in systemic levels of C-reactive protein and homocysteine.
2. To measure and compare changes in wound biomarker levels, pH, and microbial load, and changes in systemic (blood) levels of C-reactive protein and homocysteine, looking for relationships.

Treatment Stage Secondary Objectives

1. To measure and compare the incidence of adverse events experienced by subjects in each of the 2 treatment groups.
2. To measure and compare the wound characteristics of each treatment group.
3. To measure and compare the subjects' quality of life of each treatment group.
4. To measure and compare the cost effectiveness of each treatment group.
5. To measure and compare changes in wound size with changes in wound biomarker levels, pH, and microbial load; and changes in systemic (blood) levels of C-reactive protein and homocysteine.
6. To measure and compare changes in wound biomarker levels, pH, microbial load, and changes in systemic levels of C-reactive protein and homocysteine, looking for relationships within treatment groups and overall.
7. To assess the ease of using these dressing

Post-treatment Stage Secondary Objectives

Subjects whose wounds heal prior to Visit 12 are expected to have a follow-up appointment 12-14 weeks after their wound has healed. Subjects whose wounds do not heal by Visit 12 are expected to complete a follow-up appointment 12-14 weeks after their last appointment. The objectives of this are to determine the frequency of complete healing between the two treatment groups and to determine the number of wounds that had healed by the end of the treatment phase and remained healed for each group at the follow-up appointment.

The objective is to measure and compare the percentage of wounds healed by Visit 12 (or before) that remained healed at the follow-up appointment by treatment group.

Conditions

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Foot Ulcer, Diabetic

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Non-adherent Wound Dressing

The non-adherent dressing is the same as the Tegaderm Matrix dressing, with potassium chloride, rubidium chloride, calcium chloride, zinc chloride, potassium citrate and citric acid removed. This dressing is a Class I medical device (21 CFR Sec. 878.4020 Occlusive wound dressing) that is exempt from premarket notification procedures.

Group Type EXPERIMENTAL

Wound Dressing

Intervention Type DEVICE

Acetate mesh carrier with ointment (water, PEGs)

Tegaderm Matrix Dressing with PHI

A commercial wound dressing to be used per manufacturer's instructions for use.

Group Type ACTIVE_COMPARATOR

Wound Dressing

Intervention Type DEVICE

Acetate mesh carrier with ointment (water, PEGs, cations, citric acid)

Interventions

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Wound Dressing

Acetate mesh carrier with ointment (water, PEGs)

Intervention Type DEVICE

Wound Dressing

Acetate mesh carrier with ointment (water, PEGs, cations, citric acid)

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Is the subject 18 years of age or older?
2. Does the subject have a chronic full thickness diabetic foot ulcer (DFU) inferior to the malleolus that has been present for a minimum of four (4) weeks?
3. Does the diabetic foot ulcer measure greater than 1.0 cm2 and less than 25.0 cm2 after the wound is debrided?
4. Does the subject show evidence of neuropathy?
5. Is the subject's wound free of tunneling and showing no exposed periosteum or bone and free of clinical infection defined as the presence of local signs and symptoms including purulence, warmth, tenderness, pain, induration, cellulitis, bullae, crepitus, abscess, fasciitis and osteomyelitis?
6. Is the study wound able to be off loaded or achieve pressure relief and permit daily dressing changes?
7. Is the subject willing to have three (3) wound biopsies taken (Visit 0, 4 and 8)?
8. Is the subject willing to have photos taken of their wound and permit use of the photos in publications?
9. Has the subject or their legally authorized representative signed an Institutional Review Board approved informed consent document and authorized the use and disclosure of protected health information?
10. Does the subject have adequate circulation to the foot as evidenced by an Ankle Brachial Index (ABI) of 0.8 - 1.2; or if the ABI is greater than 1.2, does the subject show toe pressures \>40 mmHg, or transcutaneous oximetry (TcPO2) \> 40 mm Hg, or does the subject show adequate circulation on an arterial Doppler study? (ABI or Doppler results must be \< 45 days old.)
11. Is the subject able to comply with the protocol requirements?
12. If the subject is a woman of child bearing potential is she practicing an acceptable form of birth control as determined by the Investigator, and is she willing to have a pregnancy test?

Exclusion Criteria

1. Is the subject pregnant or breast feeding or have they given birth within the 3 weeks preceding the screening visit?
2. Has the subject been diagnosed with a malignant disease and received chemotherapy or treatment for a malignancy within the past 1 year?
3. Does the subject have an infection requiring systemic antibiotic treatment?
4. Has the subject ever received radiation therapy or other local therapy for malignancy at the extremity where the wound is located (from patient history)?
5. Is the subject currently using systemic steroids, or have they used systemic steroids within the previous 2 weeks, or are they projected to require systemic steroid use during the study as evidenced by a history of chronic systemic steroid use? (Topical steroids (except on the study extremity) and steroid inhalants will be allowed in the study.)
6. Does the subject have Lupus or Crohn's disease?
7. Does the subject have an oxygen dependency?
8. Has the subject received hyperbaric oxygen therapy within the previous 90 days?
9. Has the subject had vascular surgery relating to the wound within 30 days prior to the Screening Visit?
10. Does the subject have an active Charcot foot deformity of the foot presenting the ulcer?
11. Has the subject received Dermagraft®, Apligraf, or any other biologically active wound care product, or used Regranex Gel®, KGF, TGFβ or another topical growth factor to the study ulcer within the 30 days prior to the Screening visit?
12. Does the subject's wound require the use of topical silver, topical antibiotics, enzymatic debridement agents or other topical agents?
13. Has the subject been enrolled in any investigational study within 30 days of the Screening Visit?
14. Does the subject have any medical condition that in the opinion of the investigator should exclude him/her from participating in the study?
15. Has the subject received ultrasonic debridement or electrical stimulation within 7 days of the Screening Visit?
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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3M

INDUSTRY

Sponsor Role collaborator

Solventum US LLC

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Joseph V Boykin, MD

Role: PRINCIPAL_INVESTIGATOR

HCA Retreat Hospital

Locations

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Terry Treadwell, MD

Montgomery, Alabama, United States

Site Status

Alex Reyzelman, DPM

Castro Valley, California, United States

Site Status

Wyatt Payne, MD

Bay Pines, Florida, United States

Site Status

Vickie Driver, DPM

Boston, Massachusetts, United States

Site Status

William Marston, MD

Chapel Hill, North Carolina, United States

Site Status

Joseph Boykin, MD

Richmond, Virginia, United States

Site Status

Countries

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United States

References

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Schultz G, Mozingo D, Romanelli M, Claxton K. Wound healing and TIME; new concepts and scientific applications. Wound Repair Regen. 2005 Jul-Aug;13(4 Suppl):S1-11. doi: 10.1111/j.1067-1927.2005.1304S1.x. No abstract available.

Reference Type BACKGROUND
PMID: 16008735 (View on PubMed)

Keast DH, Bowering CK, Evans AW, Mackean GL, Burrows C, D'Souza L. MEASURE: A proposed assessment framework for developing best practice recommendations for wound assessment. Wound Repair Regen. 2004 May-Jun;12(3 Suppl):S1-17. doi: 10.1111/j.1067-1927.2004.0123S1.x.

Reference Type BACKGROUND
PMID: 15230830 (View on PubMed)

Mustoe T. Understanding chronic wounds: a unifying hypothesis on their pathogenesis and implications for therapy. Am J Surg. 2004 May;187(5A):65S-70S. doi: 10.1016/S0002-9610(03)00306-4.

Reference Type BACKGROUND
PMID: 15147994 (View on PubMed)

Falanga V. The chronic wound: impaired healing and solutions in the context of wound bed preparation. Blood Cells Mol Dis. 2004 Jan-Feb;32(1):88-94. doi: 10.1016/j.bcmd.2003.09.020.

Reference Type BACKGROUND
PMID: 14757419 (View on PubMed)

Xu L, McLennan SV, Lo L, Natfaji A, Bolton T, Liu Y, Twigg SM, Yue DK. Bacterial load predicts healing rate in neuropathic diabetic foot ulcers. Diabetes Care. 2007 Feb;30(2):378-80. doi: 10.2337/dc06-1383. No abstract available.

Reference Type BACKGROUND
PMID: 17259515 (View on PubMed)

Blakytny R, Jude E. The molecular biology of chronic wounds and delayed healing in diabetes. Diabet Med. 2006 Jun;23(6):594-608. doi: 10.1111/j.1464-5491.2006.01773.x.

Reference Type BACKGROUND
PMID: 16759300 (View on PubMed)

Steed DL. Wound-healing trajectories. Surg Clin North Am. 2003 Jun;83(3):547-55, vi-vii. doi: 10.1016/S0039-6109(02)00208-6.

Reference Type BACKGROUND
PMID: 12822725 (View on PubMed)

Robson MC, Hill DP, Woodske ME, Steed DL. Wound healing trajectories as predictors of effectiveness of therapeutic agents. Arch Surg. 2000 Jul;135(7):773-7. doi: 10.1001/archsurg.135.7.773.

Reference Type BACKGROUND
PMID: 10896369 (View on PubMed)

Margolis DJ, Gelfand JM, Hoffstad O, Berlin JA. Surrogate end points for the treatment of diabetic neuropathic foot ulcers. Diabetes Care. 2003 Jun;26(6):1696-700. doi: 10.2337/diacare.26.6.1696.

Reference Type BACKGROUND
PMID: 12766096 (View on PubMed)

Gelfand JM, Hoffstad O, Margolis DJ. Surrogate endpoints for the treatment of venous leg ulcers. J Invest Dermatol. 2002 Dec;119(6):1420-5. doi: 10.1046/j.1523-1747.2002.19629.x.

Reference Type BACKGROUND
PMID: 12485449 (View on PubMed)

Sheehan P, Jones P, Giurini JM, Caselli A, Veves A. Percent change in wound area of diabetic foot ulcers over a 4-week period is a robust predictor of complete healing in a 12-week prospective trial. Plast Reconstr Surg. 2006 Jun;117(7 Suppl):239S-244S. doi: 10.1097/01.prs.0000222891.74489.33.

Reference Type BACKGROUND
PMID: 16799391 (View on PubMed)

Steed DL, Hill DP, Woodske ME, Payne WG, Robson MC. Wound-healing trajectories as outcome measures of venous stasis ulcer treatment. Int Wound J. 2006 Mar;3(1):40-7. doi: 10.1111/j.1742-4801.2006.00178.x.

Reference Type BACKGROUND
PMID: 16650209 (View on PubMed)

Kantor J, Margolis DJ. A multicentre study of percentage change in venous leg ulcer area as a prognostic index of healing at 24 weeks. Br J Dermatol. 2000 May;142(5):960-4. doi: 10.1046/j.1365-2133.2000.03478.x.

Reference Type BACKGROUND
PMID: 10809855 (View on PubMed)

Greener B, Hughes AA, Bannister NP, Douglass J. Proteases and pH in chronic wounds. J Wound Care. 2005 Feb;14(2):59-61. doi: 10.12968/jowc.2005.14.2.26739. No abstract available.

Reference Type BACKGROUND
PMID: 15739652 (View on PubMed)

Karim RB, Brito BL, Dutrieux RP, Lassance FP, Hage JJ. MMP-2 assessment as an indicator of wound healing: A feasibility study. Adv Skin Wound Care. 2006 Jul-Aug;19(6):324-7. doi: 10.1097/00129334-200607000-00011.

Reference Type BACKGROUND
PMID: 16885646 (View on PubMed)

Pirayesh A, Dessy LA, Rogge FJ, Hoeksema HJ, Sinove YM, Dall' Antonia A, Jawad MA, Gilbert PM, Rubino C, Scuderi N, Blondeel R, Monstrey S. The efficacy of a polyhydrated ionogen impregnated dressing in the treatment of recalcitrant diabetic foot ulcers: a multi-centre pilot study. Acta Chir Belg. 2007 Nov-Dec;107(6):675-81. doi: 10.1080/00015458.2007.11680145.

Reference Type BACKGROUND
PMID: 18274183 (View on PubMed)

van Rossum M, Vooijs DP, Walboomers XF, Hoekstra MJ, Spauwen PH, Jansen JA. The influence of a PHI-5-loaded silicone membrane, on cutaneous wound healing in vivo. J Mater Sci Mater Med. 2007 Jul;18(7):1449-56. doi: 10.1007/s10856-006-0112-z. Epub 2007 Mar 27.

Reference Type BACKGROUND
PMID: 17387598 (View on PubMed)

Schmidtchen A, Wolff H, Hansson C. Differential proteinase expression by Pseudomonas aeruginosa derived from chronic leg ulcers. Acta Derm Venereol. 2001 Nov-Dec;81(6):406-9. doi: 10.1080/000155501317208336.

Reference Type BACKGROUND
PMID: 11859942 (View on PubMed)

Edwards JV, Howley PS. Human neutrophil elastase and collagenase sequestration with phosphorylated cotton wound dressings. J Biomed Mater Res A. 2007 Nov;83(2):446-54. doi: 10.1002/jbm.a.31171.

Reference Type BACKGROUND
PMID: 17477392 (View on PubMed)

Rushton I. Understanding the role of proteases and pH in wound healing. Nurs Stand. 2007 Apr 18-24;21(32):68, 70, 72 passim. doi: 10.7748/ns2007.04.21.32.68.c4499.

Reference Type BACKGROUND
PMID: 17479791 (View on PubMed)

Gethin GT, Cowman S, Conroy RM. The impact of Manuka honey dressings on the surface pH of chronic wounds. Int Wound J. 2008 Jun;5(2):185-94. doi: 10.1111/j.1742-481X.2007.00424.x.

Reference Type BACKGROUND
PMID: 18494624 (View on PubMed)

Wysocki AB, Staiano-Coico L, Grinnell F. Wound fluid from chronic leg ulcers contains elevated levels of metalloproteinases MMP-2 and MMP-9. J Invest Dermatol. 1993 Jul;101(1):64-8. doi: 10.1111/1523-1747.ep12359590.

Reference Type BACKGROUND
PMID: 8392530 (View on PubMed)

Ravanti L, Kahari VM. Matrix metalloproteinases in wound repair (review). Int J Mol Med. 2000 Oct;6(4):391-407.

Reference Type BACKGROUND
PMID: 10998429 (View on PubMed)

Muller M, Trocme C, Lardy B, Morel F, Halimi S, Benhamou PY. Matrix metalloproteinases and diabetic foot ulcers: the ratio of MMP-1 to TIMP-1 is a predictor of wound healing. Diabet Med. 2008 Apr;25(4):419-26. doi: 10.1111/j.1464-5491.2008.02414.x.

Reference Type BACKGROUND
PMID: 18387077 (View on PubMed)

Schonfelder U, Abel M, Wiegand C, Klemm D, Elsner P, Hipler UC. Influence of selected wound dressings on PMN elastase in chronic wound fluid and their antioxidative potential in vitro. Biomaterials. 2005 Nov;26(33):6664-73. doi: 10.1016/j.biomaterials.2005.04.030.

Reference Type BACKGROUND
PMID: 15978664 (View on PubMed)

Veves A, Sheehan P, Pham HT. A randomized, controlled trial of Promogran (a collagen/oxidized regenerated cellulose dressing) vs standard treatment in the management of diabetic foot ulcers. Arch Surg. 2002 Jul;137(7):822-7. doi: 10.1001/archsurg.137.7.822.

Reference Type BACKGROUND
PMID: 12093340 (View on PubMed)

Smeets R, Ulrich D, Unglaub F, Woltje M, Pallua N. Effect of oxidised regenerated cellulose/collagen matrix on proteases in wound exudate of patients with chronic venous ulceration. Int Wound J. 2008 Jun;5(2):195-203. doi: 10.1111/j.1742-481X.2007.00367.x.

Reference Type BACKGROUND
PMID: 18494625 (View on PubMed)

Lobmann R, Zemlin C, Motzkau M, Reschke K, Lehnert H. Expression of matrix metalloproteinases and growth factors in diabetic foot wounds treated with a protease absorbent dressing. J Diabetes Complications. 2006 Sep-Oct;20(5):329-35. doi: 10.1016/j.jdiacomp.2005.08.007.

Reference Type BACKGROUND
PMID: 16949521 (View on PubMed)

Fasciglione GF, Marini S, D'Alessio S, Politi V, Coletta M. pH- and temperature-dependence of functional modulation in metalloproteinases. A comparison between neutrophil collagenase and gelatinases A and B. Biophys J. 2000 Oct;79(4):2138-49. doi: 10.1016/S0006-3495(00)76461-7.

Reference Type BACKGROUND
PMID: 11023917 (View on PubMed)

Nwomeh BC, Liang HX, Cohen IK, Yager DR. MMP-8 is the predominant collagenase in healing wounds and nonhealing ulcers. J Surg Res. 1999 Feb;81(2):189-95. doi: 10.1006/jsre.1998.5495.

Reference Type BACKGROUND
PMID: 9927539 (View on PubMed)

Other Identifiers

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05-011091

Identifier Type: -

Identifier Source: org_study_id

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