Defocused Shock Wave Therapy for Chronic Wounds

NCT ID: NCT02410447

Last Updated: 2015-04-07

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

PHASE3

Total Enrollment

10 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-05-31

Study Completion Date

2015-03-31

Brief Summary

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Chronic soft tissue wounds of the lower limbs are painful and debilitating condition that significantly reduce the quality of life of the patient. They often do not respond to conservative treatments or advanced wound managements. Focused and defocused extracorporeal shock wave therapy can be a viable alternative therapeutic strategy.

The purpose of the study was to examine the effects of defocused extracorporeal shock wave treatment on chronic soft tissue wounds of the lower limbs, in terms of the rate of wound healing and pain control.

Detailed Description

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Conditions

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Wounds

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Treatment Group

Defocused shock waves were provided by an electromagnetic generator (DUOLITH® SD1 - Storz Medical AG, Tägerwilen, Switzerland).

The protocol consisted of a series of 3 sessions in 2 weeks, 2 treatments a week. For each patient, a different number of impulses per session was delivered, depending on wound size (300 impulses + 100 impulses per cm2 wound-surface), at an energy flux density of 0.15 mJ/mm2 and a frequency of 5 pulses/s.

Group Type EXPERIMENTAL

Defocused shock wave therapy (DUOLITH® SD1)

Intervention Type DEVICE

Interventions

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Defocused shock wave therapy (DUOLITH® SD1)

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* chronic post-traumatic, venous, arterial, diabetic, or mixed wound of the lower limb
* wound persisting for longer than three months
* a wound surface bigger than 0,5 cm2
* a wound diameter between 0.5 and 5 cm
* unresponsiveness to conservative treatments and advanced wound managements in the 3 months prior to enrollment
* no changes in wound managements during the study.

Exclusion Criteria

* an ankle brachial index (ABPI)\<0.7 and TcPO2\<40 mmHg
* arrhythmias, presence of pacemaker, or coagulation disorders
* use of anticoagulant drugs
* neoplasia
* pregnancy
* soft tissue wound infections and/or osteomyelitis
* patients with full-thickness loss of soft tissue and extension into muscle, bone, tendon, or joint capsule.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Roma La Sapienza

OTHER

Sponsor Role lead

Responsible Party

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Mario Vetrano, MD

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Sant'Andrea Hospital

Rome, Italy, Italy

Site Status

Countries

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Italy

References

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Schaden W, Thiele R, Kolpl C, Pusch M, Nissan A, Attinger CE, Maniscalco-Theberge ME, Peoples GE, Elster EA, Stojadinovic A. Shock wave therapy for acute and chronic soft tissue wounds: a feasibility study. J Surg Res. 2007 Nov;143(1):1-12. doi: 10.1016/j.jss.2007.01.009. Epub 2007 Sep 27.

Reference Type BACKGROUND
PMID: 17904157 (View on PubMed)

Saggini R, Figus A, Troccola A, Cocco V, Saggini A, Scuderi N. Extracorporeal shock wave therapy for management of chronic ulcers in the lower extremities. Ultrasound Med Biol. 2008 Aug;34(8):1261-71. doi: 10.1016/j.ultrasmedbio.2008.01.010. Epub 2008 Apr 18.

Reference Type BACKGROUND
PMID: 18394777 (View on PubMed)

Moretti B, Notarnicola A, Maggio G, Moretti L, Pascone M, Tafuri S, Patella V. The management of neuropathic ulcers of the foot in diabetes by shock wave therapy. BMC Musculoskelet Disord. 2009 May 27;10:54. doi: 10.1186/1471-2474-10-54.

Reference Type BACKGROUND
PMID: 19473538 (View on PubMed)

Arno A, Garcia O, Hernan I, Sancho J, Acosta A, Barret JP. Extracorporeal shock waves, a new non-surgical method to treat severe burns. Burns. 2010 Sep;36(6):844-9. doi: 10.1016/j.burns.2009.11.012. Epub 2010 Jan 13.

Reference Type BACKGROUND
PMID: 20071091 (View on PubMed)

Mittermayr R, Antonic V, Hartinger J, Kaufmann H, Redl H, Teot L, Stojadinovic A, Schaden W. Extracorporeal shock wave therapy (ESWT) for wound healing: technology, mechanisms, and clinical efficacy. Wound Repair Regen. 2012 Jul-Aug;20(4):456-65. doi: 10.1111/j.1524-475X.2012.00796.x. Epub 2012 May 29.

Reference Type BACKGROUND
PMID: 22642362 (View on PubMed)

Haupt G, Chvapil M. Effect of shock waves on the healing of partial-thickness wounds in piglets. J Surg Res. 1990 Jul;49(1):45-8. doi: 10.1016/0022-4804(90)90109-f.

Reference Type BACKGROUND
PMID: 2359293 (View on PubMed)

Kuo YR, Wang CT, Wang FS, Yang KD, Chiang YC, Wang CJ. Extracorporeal shock wave treatment modulates skin fibroblast recruitment and leukocyte infiltration for enhancing extended skin-flap survival. Wound Repair Regen. 2009 Jan-Feb;17(1):80-7. doi: 10.1111/j.1524-475X.2008.00444.x.

Reference Type BACKGROUND
PMID: 19152654 (View on PubMed)

Wang CJ, Wu RW, Yang YJ. Treatment of diabetic foot ulcers: a comparative study of extracorporeal shockwave therapy and hyperbaric oxygen therapy. Diabetes Res Clin Pract. 2011 May;92(2):187-93. doi: 10.1016/j.diabres.2011.01.019. Epub 2011 Apr 6.

Reference Type BACKGROUND
PMID: 21310502 (View on PubMed)

Mariotto S, Cavalieri E, Amelio E, Ciampa AR, de Prati AC, Marlinghaus E, Russo S, Suzuki H. Extracorporeal shock waves: from lithotripsy to anti-inflammatory action by NO production. Nitric Oxide. 2005 Mar;12(2):89-96. doi: 10.1016/j.niox.2004.12.005.

Reference Type BACKGROUND
PMID: 15740982 (View on PubMed)

Ohtori S, Inoue G, Mannoji C, Saisu T, Takahashi K, Mitsuhashi S, Wada Y, Takahashi K, Yamagata M, Moriya H. Shock wave application to rat skin induces degeneration and reinnervation of sensory nerve fibres. Neurosci Lett. 2001 Nov 23;315(1-2):57-60. doi: 10.1016/s0304-3940(01)02320-5.

Reference Type BACKGROUND
PMID: 11711214 (View on PubMed)

Kuo YR, Wang CT, Wang FS, Chiang YC, Wang CJ. Extracorporeal shock-wave therapy enhanced wound healing via increasing topical blood perfusion and tissue regeneration in a rat model of STZ-induced diabetes. Wound Repair Regen. 2009 Jul-Aug;17(4):522-30. doi: 10.1111/j.1524-475X.2009.00504.x.

Reference Type BACKGROUND
PMID: 19614917 (View on PubMed)

Hayashi D, Kawakami K, Ito K, Ishii K, Tanno H, Imai Y, Kanno E, Maruyama R, Shimokawa H, Tachi M. Low-energy extracorporeal shock wave therapy enhances skin wound healing in diabetic mice: a critical role of endothelial nitric oxide synthase. Wound Repair Regen. 2012 Nov-Dec;20(6):887-95. doi: 10.1111/j.1524-475X.2012.00851.x. Epub 2012 Oct 30.

Reference Type BACKGROUND
PMID: 23110611 (View on PubMed)

Larking AM, Duport S, Clinton M, Hardy M, Andrews K. Randomized control of extracorporeal shock wave therapy versus placebo for chronic decubitus ulceration. Clin Rehabil. 2010 Mar;24(3):222-9. doi: 10.1177/0269215509346083. Epub 2010 Feb 15.

Reference Type BACKGROUND
PMID: 20156981 (View on PubMed)

Stieger M, Schmid JP, Bajrami S, Hunziker T. [Extracorporeal shock wave therapy as a treatment of a non-healing chronic leg ulcer]. Hautarzt. 2013 Jun;64(6):443-6. doi: 10.1007/s00105-012-2527-4. German.

Reference Type BACKGROUND
PMID: 23322179 (View on PubMed)

Omar MT, Alghadir A, Al-Wahhabi KK, Al-Askar AB. Efficacy of shock wave therapy on chronic diabetic foot ulcer: a single-blinded randomized controlled clinical trial. Diabetes Res Clin Pract. 2014 Dec;106(3):548-54. doi: 10.1016/j.diabres.2014.09.024. Epub 2014 Oct 5.

Reference Type BACKGROUND
PMID: 25451894 (View on PubMed)

Wolff KS, Wibmer A, Pusch M, Prusa AM, Pretterklieber M, Teufelsbauer H, Schaden W. The influence of comorbidities and etiologies on the success of extracorporeal shock wave therapy for chronic soft tissue wounds: midterm results. Ultrasound Med Biol. 2011 Jul;37(7):1111-9. doi: 10.1016/j.ultrasmedbio.2011.04.007. Epub 2011 Jun 2.

Reference Type BACKGROUND
PMID: 21640475 (View on PubMed)

Wang CJ, Kuo YR, Wu RW, Liu RT, Hsu CS, Wang FS, Yang KD. Extracorporeal shockwave treatment for chronic diabetic foot ulcers. J Surg Res. 2009 Mar;152(1):96-103. doi: 10.1016/j.jss.2008.01.026. Epub 2008 Mar 7.

Reference Type BACKGROUND
PMID: 18619622 (View on PubMed)

Other Identifiers

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2

Identifier Type: -

Identifier Source: org_study_id

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