Gene Expression Profiles in Healing and Non-Healing Wounds (WHGS1)
|Wounds and Injuries|
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||Gene Expression Profiles in Healing and Non-Healing Wounds|
- Gene Expression Profiles [ Time Frame: 12 weeks ]Will be determined using gene chip. This yields data in the form of relative rates of gene expression.
- Composite Data for Necrotic and Slough Tissue (N) [ Time Frame: 12 months ]Necrotic and slough tissue (N) will be analyzed for the presence and structure of biofilm, pathogen identification via mass spectrometry and culture. Cultured bacteria will be tested for antibiotic resistance.
- Gene Chip Findings [ Time Frame: 1 year or more ]Gene chip findings healing versus non healing wounds.
- Composite Subgroup Analyses [ Time Frame: 12 months ]
The following groups of patients will be analyzed for common patterns of gene expression using software specifically designed to analyze gene chip results:
- Healing vs. non-healing
- Age >/= 70 vs. age <70
- Diabetic ulcers
i. With neuropathy ii. Without neuropathy d. Pressure sores i. With spinal cord injury ii. Without spinal cord injury e. Venous stasis ulcers f. Autoimmune-mediated ulcers g. Radiation-induced ulcers h. Acute wounds i. Surgical site ii. Traumatic injury iii. Burn
Biospecimen Retention: Samples With DNA
|Study Start Date:||December 2004|
|Estimated Study Completion Date:||December 2020|
|Estimated Primary Completion Date:||December 2020 (Final data collection date for primary outcome measure)|
A single subject (current OSU Comprehensive Wound Center patient) will provide 2 tissue samples (3 mm punch biopsies performed by a wound care physician) from a single wound over a 4-week time period.
A single subject (current OSU Comprehensive Wound Center patient) will provide 1 debrided tissue sample as part of their standard wound care treatment (no new wounds will be created). The subject's wound care physician will perform the debridement during an office visit or in the operating room (OR) during surgical debridement.
This study has two arms: 1) the biopsy arm and 2) the debridement arm. The purpose of the biopsy arm is to determine whether there are similar patterns of genes being turned on and/or turned off among people with healing and non-healing wounds. The purpose of the debridement arm is to (i) identify the nature of bacterial infection and the genes driving the tissue response to it; and (ii) determine how the biofilm components arrest/paralyze the immune function.
For the biopsy arm, a single subject (current OSU Comprehensive Wound Center patient) will provide 2 tissue samples (3 mm punch biopsy samples collected by a wound care physician) from a single wound over a 4-week time period. The wound and the samples will be categorized as healing versus non-healing responses on the basis of decreased (healing) or increased (non-healing) wound area measurements over the 4-week time period. A chronic wound generally is a wound which shows no signs of significant healing in four weeks or has not healed in eight weeks. The ability to obtain additional measurements from patients' medical records up to 12 weeks after enrollment in the study will confirm the healing or non-healing trajectory of the wound.
For the debridement arm, a single subject (current OSU Comprehensive Wound Center patient) will be seen 1 time at the CWC during their regularly scheduled wound care visits or during your scheduled surgery and debrided tissue (foreign matter and dead tissue from a wound) that is ordinarily discarded will be collected. No additional wound care visits will be required as all study-related visits will happen during regularly scheduled appointments at an OSU Comprehensive Wound Center or in the operating room (OR) (if a patient's physician determines that surgical debridement is required). The ability to obtain additional measurements from patients' medical records up to 12 weeks after enrollment in the study will confirm the healing or non-healing trajectory of the wound. Debrided tissue that is collected will be divided into three parts: A) Necrotic/slough tissue (N); B) Live tissue determined by consistency and pinkish color, but not perfused (LNP); or C) Red perfused tissue (LP). If it is difficult to clearly distinguish between the LNP and LP, the two groups will be combined together. In an effort to identify the infection markers of normal or impaired healing, we plan to create a database that contains pathogen type, gene and protein expression profiles and enzymatic activity from infected human wound specimens.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01101854
|Contact: David Paoletto, RN, BAfirstname.lastname@example.org|
|Contact: Elizabeth Murphy, BSemail@example.com|
|United States, Ohio|
|Comprehensive Wound Center, The Ohio State University Wexner Medical Center||Recruiting|
|Columbus, Ohio, United States, 43221|
|Contact: David Paoletto, RN, BA 614-366-3515 firstname.lastname@example.org|
|Principal Investigator: Gayle Gordillo, MD|
|Sub-Investigator: Chandan Sen, PhD|
|Sub-Investigator: Richard E. Schlanger, M.D.|
|Principal Investigator:||Gayle Gordillo, MD||Ohio State University|