ActiV.A.C.+ Compression Therapy Versus Compression Therapy Alone for the Treatment of Chronic Venous Ulcerations
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Purpose
This is a prospective, randomized, comparative interventional human subject trial. Patients with a chronic venous ulceration of the lower extremity will be enrolled into this study. These wounds must be recalcitrant to the standard treatment regimen. There are a total of two arms in this study. One group will be randomly assigned to the Acti VAC + Compression therapy group consisting of the application of this device along with compression therapy. The other group will be randomly assigned into compression therapy only group. A total of 60 subjects will be enrolled into this 6 week study. There will be a 2 week run-in period (prior to the onset of the intervention) to ensure that the wound has not healed greater than 35% prior to intervention and randomization. Wounds that heal within the 6 week trial period will have an additional confirmatory visit 2 weeks after healing was identified.
If within the 6 week intervention period the wound bed is determined to be ready for a Split Thickness Skin Graft (STSG) or Bio-engineered Alternative Tissue (BAT), the surgery or clinic application will be scheduled within 4 weeks. Subjects deemed not to be a surgical candidate, will have Bio-engineered Alternative Tissue (BAT) application in the clinic. This includes patients who are medically unstable to receive a medical clearance for surgery or otherwise not a candidate for Split Thickness Skin Graft (STSG) surgery (e.g. donor site skin is compromised). During this period between the scheduled STSG surgery or BAT application, the subjects will continue within the assigned treatment group. A confirmatory visit will also occur 2 weeks after the application of a Split Thickness Skin Graft (STSG) or Bio-engineered Alternative Tissue (BAT).
Patients diagnosed with a chronic venous ulceration will be assessed for study eligibility during their initial clinical evaluation. Patients who meet the eligibility requirements will be asked to enroll into the study (see Subject Recruitment). Subjects will be asked to sign the informed consent form and receive a copy of the informed consent.
| Condition | Intervention |
|---|---|
|
Chronic Venous Hypertension With Ulcer |
Device: ActiVAC System + Compression therapy |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Crossover Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Prospective, Randomized, Comparative Effectiveness Trial of the ActiV.A.C.+ Compression Therapy Versus Compression Therapy Alone for the Treatment of Chronic Venous Ulcerations |
- Compare wound healing [ Time Frame: 6 weeks ] [ Designated as safety issue: No ]Wound healing between the ActiV.A.C. System + Compression therapy versus Compression therapy alone in patients with chronic venous ulcerations.
- Compare the time to wound bed preparation, quality of life, degree of Split Thickness Skin Graft/Bio-engineered Alternative Tissue take [ Time Frame: 9 weeks ] [ Designated as safety issue: No ]-Compare the time to wound bed preparation between the ActiV.A.C. System + Compression therapy versus Compression therapy alone in patients with chronic venous ulcerations.
- Quality of Life [ Time Frame: 9 weeks ] [ Designated as safety issue: No ]Quality of life between ActiV.A.C. System + Compression therapy versus Compression therapy alone in patients with chronic venous ulcerations.
- Degree of take [ Time Frame: 6 Weeks ] [ Designated as safety issue: No ]Degree of split thickness skin graft taken or bioengineered alternative tissue induced wound shrinkage after 6 weeks of ActiV.A.C. System + Compression therapy versus Compression therapy alone in patients with chronic venous ulcerations.
| Estimated Enrollment: | 60 |
| Study Start Date: | July 2012 |
| Estimated Study Completion Date: | July 2014 |
| Estimated Primary Completion Date: | July 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: ActiVAC System+ Compression therapy
ActiVAC System + Compression therapy group consisting of the application of this device along with compression therapy.
|
Device: ActiVAC System + Compression therapy
The ActiV.A.C. System will be applied in a customary manner per manufacturer's recommendations. Acticoat Flex 7™ will be applied as contact layer on the wound surface. Open cell foam is then applied over the top of the Acticoat Flex 7™. Adherent transparent occlusive material will be applied over the open cell foam. The tubing is then attached after cutting a small aperture through the occlusive material. Negative pressure will be set at 125mmHg on continuous suction. Sponge and canister will be replaced 2 time a week. Compression Therapy Profore™ multi-layered compression bandaging system will be utilized. This includes the application of a contact layer dressing using Acticoat Flex 7™. The compression bandage will be applied per manufacturer's recommendations. Other Name: ActiV.A.C System
|
|
compression therapy only
Standard of Care compression therapy only
|
Device: ActiVAC System + Compression therapy
The ActiV.A.C. System will be applied in a customary manner per manufacturer's recommendations. Acticoat Flex 7™ will be applied as contact layer on the wound surface. Open cell foam is then applied over the top of the Acticoat Flex 7™. Adherent transparent occlusive material will be applied over the open cell foam. The tubing is then attached after cutting a small aperture through the occlusive material. Negative pressure will be set at 125mmHg on continuous suction. Sponge and canister will be replaced 2 time a week. Compression Therapy Profore™ multi-layered compression bandaging system will be utilized. This includes the application of a contact layer dressing using Acticoat Flex 7™. The compression bandage will be applied per manufacturer's recommendations. Other Name: ActiV.A.C System
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Subjects between 18-75 years of age
- Subject able and willing to comply with study protocol requirements and able to understand the informed consent
- Non-pregnant female willing to take urine pregnancy test
Chronic venous ulceration of the lower extremity
- Defined: wound of greater than 1 month in duration
- Diagnosis based on clinical assessment and/or venous studies
- <100 cm2 area and <10cm at the widest diameter
Exclusion Criteria:
- Active infection (redness, swelling, pain, purulence)
- Untreated osteomyelitis or current osteomyelitis
- Allergy or sensitivity to wound study products
- Malignancy
- Plantar surface wounds
- BMI (Body Mass Index) ≥50
- Uncontrolled diabetes (HbA1c>12%) at the time of study screening
- End stage renal disease
- Undergoing chemotherapy/radiation therapy
- Non-dopplerable pedal pulses or otherwise diagnosed with peripheral arterial disease or any contraindication to compression therapy
- Any previous wound care therapy including negative pressure therapy, ultrasound therapy, BAT, or STSG within the previous 30 days of enrollment; this excludes compression therapy
- Greater than 35% wound surface area reduction in size at 2 weeks after initial screening visit
- Pregnancy
- Subject has any condition that, in the opinion of the investigator, makes the subject inappropriate to take part in this study
- Subject unwilling or unable to comply with protocol requirements
Contacts and Locations| Contact: Paul Kim, DPM | 202-444-0469 | Paul.J.Kim@gunet.georgetown.edu |
| Contact: Mallory W Nichols, B.S | 202-444-0283 | Mallory.W.Nichols@gunet.georgetown.edu |
| United States, District of Columbia | |
| Georgetown University Hospital, Center for Wound Healing | Recruiting |
| Washington, District of Columbia, United States, 20007 | |
| Principal Investigator: Christopher Attinger, MD | |
| Sub-Investigator: John Steinberg, DPM | |
| Sub-Investigator: Paul Kim, DPM | |
| Sub-Investigator: Karen K. Evans, MD | |
| Principal Investigator: | Christopher Attinger, M.D | Georgetown University Hospital |
| Study Director: | Paul Kim, DPM | Georgetown University Hospital |
More Information
No publications provided
| Responsible Party: | Christopher Attinger, M.D., Director, Wound Healing Clinic, Georgetown University |
| ClinicalTrials.gov Identifier: | NCT01528293 History of Changes |
| Other Study ID Numbers: | ActiVac |
| Study First Received: | January 27, 2012 |
| Last Updated: | March 29, 2013 |
| Health Authority: | United States: Food and Drug Administration |
Additional relevant MeSH terms:
|
Hypertension Ulcer Varicose Ulcer Vascular Diseases Cardiovascular Diseases |
Pathologic Processes Varicose Veins Leg Ulcer Skin Ulcer Skin Diseases |
ClinicalTrials.gov processed this record on May 23, 2013