Intramedullary Calcium Sulfate Antibiotic Depot

NCT ID: NCT05766670

Last Updated: 2025-12-15

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

497 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-04-08

Study Completion Date

2028-01-31

Brief Summary

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The goal of this randomized clinical trial is to study the best treatment for open lower leg fractures to prevent infection. The main questions it aims to answer is if treating tibia fracture patients with a calcium sulfate antibiotic depot is better at preventing infection that the standard of care.

Detailed Description

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This research is a randomized clinical trial aimed to reduce the frequency of fracture related infections following open tibia fracture. The proposed test methods for infection reduction is use of an antibiotic depot placed inside the bone at the time of final fracture treatment. This is in addition to standard of care wound care, fracture fixation with intramedullary nailing, and peri-operative systemic antibiotics.

This prospective randomized clinical trial will compare outcomes between patients treated with an antibiotic depot placed inside the bone at the time of final fracture fixation and those treated with traditional standard of care intramedullary nailing.

The target population for the proposed study is patients with severe open tibia fractures (Type II or III) who require definitive fixation with intramedullary nail recruited form one of the participating sites during the index hospitalization.

One group will be treated prophylactically suing a calcium sulfate antibiotic depot at the time of definitive fixation, while the second group will be treated with a standard of care intramedullary nail without the antibiotic depot.

Participants will be followed for 12 months (data capture includes patient interviews and clinical data capture from the treatment team and medical record at baseline, 6 weeks, 3 months, 6 months, and 12 months).

Conditions

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Open tíbia Fracture Osteomyelitis Tibia Tibial Fractures

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Intramedullary calcium sulfate antibiotic depot prior to Intramedullary nailing (IMN) placement (CS)

The intramedullary calcium sulfate antibiotic depot will be mixed sterilely to include at minimum 20cc calcium sulfate powder mixed with 1g of vancomycin powder and 1.2g of tobramycin powder per 10cc of calcium sulfate.

Group Type OTHER

Vancomycin Hydrochloride

Intervention Type DRUG

The intramedullary calcium sulfate antibiotic depot will be mixed sterilely to include at minimum 20cc calcium sulfate powder mixed with 1g of vancomycin powder and 1.2g of tobramycin powder per 10cc of calcium sulfate.

Gentamicin

Intervention Type DRUG

The intramedullary calcium sulfate antibiotic depot will be mixed sterilely to include at minimum 20cc calcium sulfate powder mixed with 1g of vancomycin powder and 1.2g of tobramycin powder per 10cc of calcium sulfate.

Standard of care intramedullary nail (SN)

Standard of care intramedullary nail

Group Type OTHER

Standard Intramedullary Nail

Intervention Type OTHER

Standard Intramedullary Nail

Interventions

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Vancomycin Hydrochloride

The intramedullary calcium sulfate antibiotic depot will be mixed sterilely to include at minimum 20cc calcium sulfate powder mixed with 1g of vancomycin powder and 1.2g of tobramycin powder per 10cc of calcium sulfate.

Intervention Type DRUG

Gentamicin

The intramedullary calcium sulfate antibiotic depot will be mixed sterilely to include at minimum 20cc calcium sulfate powder mixed with 1g of vancomycin powder and 1.2g of tobramycin powder per 10cc of calcium sulfate.

Intervention Type DRUG

Standard Intramedullary Nail

Standard Intramedullary Nail

Intervention Type OTHER

Other Intervention Names

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antibacterial prescription medicine injection is used to treat certain serious infections that are caused by bacteria such as meningitis metal rod that is inserted into the medullary cavity of a bone and across the fracture in order to provide a solid support for the fractured bone

Eligibility Criteria

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Inclusion Criteria

* Patients 18 years and older
* Type II or III open tibia fracture requiring definitive fixation with intramedullary nail

Exclusion Criteria

* Less than 18 years of age
* Allergy to vancomycin or tobramycin
* Hypercalcemia
* Unable to speak English or Spanish
* No email, phone, or other point of contact
* Pregnant and lactating women
* Prisoner
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Wake Forest University Health Sciences

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Rachel B Seymour, PhD

Role: PRINCIPAL_INVESTIGATOR

Wake Forest University Health Sciences

Jessica Rivera, MD

Role: PRINCIPAL_INVESTIGATOR

Louisiana State University Health Science Center

Locations

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Cedars-Sinai

Los Angeles, California, United States

Site Status RECRUITING

Atrium Health Navicent The Medical Center

Macon, Georgia, United States

Site Status RECRUITING

University of Kentucky

Lexington, Kentucky, United States

Site Status NOT_YET_RECRUITING

Louisiana State University Health Sciences Center

New Orleans, Louisiana, United States

Site Status RECRUITING

Atrium Health Carolinas Medical Center

Charlotte, North Carolina, United States

Site Status RECRUITING

Atrium Health Cabarrus

Concord, North Carolina, United States

Site Status RECRUITING

Atrium Health Wake Forest Baptist Medical Center

Winston-Salem, North Carolina, United States

Site Status RECRUITING

Pennsylvania State University

Hershey, Pennsylvania, United States

Site Status RECRUITING

Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status NOT_YET_RECRUITING

Valley Health

Winchester, Virginia, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Christine Churchill, MA

Role: CONTACT

7043552000

Rachel B Seymour, PhD

Role: CONTACT

7043552000

Facility Contacts

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Geoffrey Marecek, MD

Role: primary

Joel Arnold

Role: backup

Jarrod Dumpe, MD

Role: primary

Adithi Shyam

Role: backup

Paul Matuszewski, MD

Role: primary

Matthew Eubank, BSN

Role: backup

Jessica Rivera, MD

Role: primary

Carolyn Bridgman

Role: backup

Joseph Hsu, MD

Role: primary

Christine Churchill, MA

Role: backup

Luke Harmer, MD

Role: primary

Erica Grochowski, MPH

Role: backup

Christine Churchill, MA

Role: primary

704-355-2000

Jana Davis, MD

Role: primary

Andrea Myers

Role: backup

William Obremskey

Role: primary

Karen Trochez

Role: backup

Ken Nelson, MD

Role: primary

Ashley Zelaski

Role: backup

Other Identifiers

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W81XWH-22-10937

Identifier Type: OTHER

Identifier Source: secondary_id

W81XWH-22-10937

Identifier Type: -

Identifier Source: org_study_id

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