Bioengineered Skin and Wound Healing

This study has been completed.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Roger Williams Medical Center
ClinicalTrials.gov Identifier:
NCT00007280
First received: December 16, 2000
Last updated: August 1, 2013
Last verified: April 2008

December 16, 2000
August 1, 2013
October 2000
August 2005   (final data collection date for primary outcome measure)
Measurement and characterization of stimulation of the wound's edges treated with the bioengineered skin construct (BSC) [ Time Frame: Measured throughout the study till Week 48 ] [ Designated as safety issue: No ]
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Complete list of historical versions of study NCT00007280 on ClinicalTrials.gov Archive Site
  • Response of BSC to injury, including meshed (wounded) and unmeshed BSC [ Time Frame: Measured throughout the study till Week 48 ] [ Designated as safety issue: No ]
  • Activation of certain critical cytokines, including IL-1 alpha, IL-6, and TGF-beta [ Time Frame: Measured throughout the study till Week 48 ] [ Designated as safety issue: No ]
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Bioengineered Skin and Wound Healing
Mechanisms of Bioengineered Skin in Human Wounds

This study will look at whether a graft of bioengineered skin (BSC), known commercially as Apligraf, stimulates the healing process in a person's own skin at the edge of a wound (known as the edge effect). The information from this study will provide a better understanding of the ways that grafts of bioengineered skin help the healing of chronic wounds.

We will assign study participants to either the bioengineered skin group or the control group. People in the control group will receive compression therapy with a multilayered compression bandage. We will examine each participant before starting treatment and then once a week for 24 weeks or until the wound heals. On the first day of treatment (day 0) and at week 3, week 6, and week 24 (end of treatment) we will take a small tissue sample from the wound for a biopsy. After the wound is completely healed, we will ask the patient to return once a month for 6 months to make sure the wound stays healed.

BSC is a two-layered sheet made from purified beef tendon collagen, living human cells, and a substance that maintains the cells until they are grafted (removed). We will obtain human cells from donors unrelated to the patient. The human cells have been tested for the presence of infectious agents and found to be free of disease-causing organisms such as hepatitis virus, the AIDS virus, bacteria, and fungi.

We will randomly assign (randomize) study participants to either the bioengineered skin group or control group (compression therapy with a multilayered compression bandage). Regardless of the group to which a patient is assigned, we expect participation in this study for 12 months following the start of study treatment. We will examine each patient at the screening visit (2 weeks before randomization) and then again 3-4 days before the start of treatment to make sure the wound is free of any signs of infection. After the initial randomization visit we will examine the wound once a week for 24 weeks or until the wound heals, whichever is earlier. As soon as we have determined that the wound is completely healed, we will ask the patient to return once a month for 6 months to make sure it remains healed.

Bioengineered skin group: We will apply BSC to the wound and cover it with xeroform dressing, foam bolster, gauze dressing, and compression bandage. If we do not note any improvement at the week 6 visit, we will apply BSC on the wound a second time.

Control group: We will place a multilayered compression bandage on the wound of participants assigned to this group.

Biopsies (small piece of skin tissue): At day 0 a biopsy will be taken from the thigh and leg ulcer. The biopsy from the thigh will require sutures and will be removed in ten days. Sometime between weeks 1 and 3, week 6, week 24 and week 48 (6 month follow-up) visits a biopsy will be taken from the ulcer (wound) if the ulcer has not healed. If the ulcer is healed at the week 48 visit, a light scraping of the healed wound will be performed.

Study examinations: All study examinations will include observation, measurement, and photography.

We can only admit women of childbearing age to the study if they are not breast feeding, not pregnant, or have been surgically sterilized or are using effective birth control. Because the effects of the proposed treatments on a fetus are unknown, we will remove from the study any woman who becomes pregnant while receiving BSC applications (day 0-week 3) and suggest another method of treatment.

Interventional
Phase 1
Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Double Blind (Subject, Investigator)
Primary Purpose: Treatment
Leg Ulcers
Device: Bioengineered skin
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
50
August 2005
August 2005   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Men or women at least 18 years old
  • At least one ulcer (wound) greater than or equal to 2 centimeters
  • Ulcer (wound) present for at least 3 months or greater
  • Ankle/brachial index > 0.7
  • Patient must be ambulatory
  • Patient must read, understand and sign informed consent

Exclusion Criteria:

  • Medical conditions limiting participation
  • History of poor compliance, unreliability
  • History of allergy to bovine collagen
  • Gangrene, vasculitis, collagen vascular disease osteomyelitis or exposed tendons
  • Use of systemic steroids/immunosuppressives
  • History of diabetes mellitus
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00007280
R01 AR46557, R01AR046557, NIAMS-060
Not Provided
Roger Williams Medical Center
Roger Williams Medical Center
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Principal Investigator: Vincent Falanga, MD Roger Williams Medical Center
Roger Williams Medical Center
April 2008

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP