Maggot Debridement Therapy Versus Conventional Dressing Therapy to Treat Diabetic Foot Ulcers

NCT ID: NCT02816749

Last Updated: 2016-07-01

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

138 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-06-30

Study Completion Date

2017-02-28

Brief Summary

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This is a prospective study of participants with diabetic foot ulcers who will receive either maggot debridement therapy (MDT) or conventional dressing therapy (CDT). Wound healing time is the main outcome measure to compare the clinical efficacy of these two therapies. The investigators developed a hypothesis that MDT could achieve remarkable shorter time and better healing rate for wound closure when compared with CDT.

Detailed Description

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The investigators designed a prospective randomized study to compare the clinical safety and efficacy of maggot debridement therapy (MDT) and conventional dressing therapy (CDT). This study is scheduled from July 2016 to February 2017. Patients, aged from 18-80, who suffered from type 2 diabetic mellitus foot ulcers with Grade 1 or Grade 2 according to the Wagner classification could be the participants of this study. A sample of 138 participants was calculated based on the morbidity of diabetic foot ulcers, accounting for estimated 10% attrition rate. The glycemic control is important for the validity of study results. A specific team of endocrine doctors will manage the blood glucose of participants of two groups within the range of 7-10 mmol/L.

Participants will be allocated into MDT group and CDT group randomly according to the random number table. For MDT-participants, bio-bags containing sterilized, live, medicinal Lucilia sericata larvae will be placed on the wound of ulcers. For CDT-participants, conventional dressing (disinfected by iodophor, dressed by gauze ) will be performed ordinally. Every 3 days the procedures of two groups will be performed and wounds assessment will be done until the wounds closure is achieved. The wounds assessment, including measurement of the area of wound surface and bacterial culture, will be performed by a specific team of microsurgical doctors. The outcome measures include wound healing time (days) and the time negative bacterial culture occurs (days). The secondary outcome measures include the area of wound surface (cm2), treatment related pain, comfort of the dressing and adverse events.

Conditions

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Diabetic Foot Ulcers

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Maggot debridement therapy(MDT)

Participant will receive bio-bags treatment every 3 days until the wound heal completely, when wounds assessed.

Group Type EXPERIMENTAL

Maggot debridement therapy

Intervention Type PROCEDURE

Participant will receive bio-bags treatment every 3 days until the wound heal completely, when wounds assessed.

Conventional Dressing Therapy(CDT)

Participant will be disinfected by iodophor and dressed by gauze 3 days until the wound heal completely, when wounds assessed.

Group Type ACTIVE_COMPARATOR

Conventional Dressing Therapy

Intervention Type PROCEDURE

Participant will be disinfected by iodophor and dressed by gauze 3 days until the wound heal completely, when wounds assessed.

Interventions

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Maggot debridement therapy

Participant will receive bio-bags treatment every 3 days until the wound heal completely, when wounds assessed.

Intervention Type PROCEDURE

Conventional Dressing Therapy

Participant will be disinfected by iodophor and dressed by gauze 3 days until the wound heal completely, when wounds assessed.

Intervention Type PROCEDURE

Other Intervention Names

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MDT Maggot Therapy Larvae Therapy CDT Occlusive Dressings Dressing Therapy

Eligibility Criteria

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Inclusion Criteria

1. Participants aged from 18-80 years old.
2. Participants with type 2 diabetes mellitus longer than one year, foot ulcer longer than three weeks and with ischemic symptoms of lower limb.
3. The ulcer erosion depth is not reached and muscle layer.
4. The Wagner classification of ulcers should be Grade 1 or Grade 2.
5. Blood glucose control: Fasting blood glucose ≤ 8mmol / L; Postprandial blood glucose two hours ≤ 11.1 mmol / L.
6. Participants do not receive ulcer wound management in the past three days when recruited.
7. Participants with neuropathy symptoms, such as limb numbness, tingling or pain, especially pain at night.

Exclusion Criteria

1. Participants with acute thrombosis that required thrombolysis or thrombectomy.
2. Participants with severe systemic infection.
3. Participants who are sensitive to pain.
4. Participants with bone/joint deformities of foot (eagle claw toes, hammer toes)
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The First Affiliated Hospital of Dalian Medical University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Shou-Yu Wang, Dr

Role: PRINCIPAL_INVESTIGATOR

The First Affiliated Hospital of Dalian Medical University

Locations

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the Second Affiliated Hospital of Dalian Medical University

Dalian, Liaoning, China

Site Status ENROLLING_BY_INVITATION

the First Affiliated Hospital of Dalian Medical University

Dalian, Liaoning, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Jun-Wei Zong

Role: CONTACT

8618098876071

Shou-Yu Wang, Dr

Role: CONTACT

86041186110147

Facility Contacts

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Chengchun Qu

Role: primary

86-0411-83635963 ext. 3015

Yinan Wang

Role: backup

86-0411-83635963 ext. 3037

References

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Pinheiro MA, Ferraz JB, Junior MA, Moura AD, da Costa ME, Costa FJ, Neto VF, Neto RM, Gama RA. Use of maggot therapy for treating a diabetic foot ulcer colonized by multidrug resistant bacteria in Brazil. Indian J Med Res. 2015 Mar;141(3):340-2. doi: 10.4103/0971-5916.156628.

Reference Type BACKGROUND
PMID: 25963495 (View on PubMed)

Sun X, Jiang K, Chen J, Wu L, Lu H, Wang A, Wang J. A systematic review of maggot debridement therapy for chronically infected wounds and ulcers. Int J Infect Dis. 2014 Aug;25:32-7. doi: 10.1016/j.ijid.2014.03.1397. Epub 2014 May 16.

Reference Type BACKGROUND
PMID: 24841930 (View on PubMed)

Shi E, Shofler D. Maggot debridement therapy: a systematic review. Br J Community Nurs. 2014 Dec;Suppl Wound Care:S6-13. doi: 10.12968/bjcn.2014.19.Sup12.S6.

Reference Type BACKGROUND
PMID: 25478859 (View on PubMed)

Sherman RA, Shapiro CE, Yang RM. Maggot therapy for problematic wounds: uncommon and off-label applications. Adv Skin Wound Care. 2007 Nov;20(11):602-10. doi: 10.1097/01.ASW.0000284943.70825.a8.

Reference Type BACKGROUND
PMID: 17975368 (View on PubMed)

Other Identifiers

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DMUF-01

Identifier Type: -

Identifier Source: org_study_id

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