Effects of Non Contact Low Frequency Ultrasound in Healing Venous Leg Ulcers

This study has been completed.
Information provided by (Responsible Party):
Celleration, Inc.
ClinicalTrials.gov Identifier:
First received: March 7, 2012
Last updated: July 2, 2015
Last verified: July 2015
This trial is a prospective, randomized, controlled, multi-center study of subjects presenting with chronic lower extremity venous ulcers. The study will evaluate the safety and effectiveness of MIST Therapy® plus standard of care (MIST+SOC) compared to Standard of Care (SOC) alone in the treatment of lower extremity venous ulcers.

Condition Intervention
Venous Insufficiency
Venous Reflux
Lower Extremity Ulcer
Device: MIST Therapy

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: IN-BALANCE VLU Inflammation, Bacteria, & Angiogenesis Effects in Launching Venous Leg Ulcer Healing

Resource links provided by NLM:

Further study details as provided by Celleration, Inc.:

Primary Outcome Measures:
  • Wound Area Mean Percent Reduction [ Time Frame: 4 weeks post baseline visit (randomization visit) ] [ Designated as safety issue: No ]

    Compare between the treatment groups percent wound area reduction at four weeks of study treatment.

    H0: µMIST+SC -- µSC = 0 HA: µMIST+SC -- µSC ≠ 0 Where µ = percent reduction in wound size.

Secondary Outcome Measures:
  • Heal Rates [ Time Frame: 12 weeks post randomization ] [ Designated as safety issue: No ]
    Compare rate of wound closure between study arms for 12 weeks post randomization. Descriptive statistics as not a powered endpoint.

  • Change in Pain VAS Scores [ Time Frame: Baseline, 2 weeks and 4 weeks post randomization ] [ Designated as safety issue: No ]

    Compare VAS Pain Scores between arms at baseline and 4 weeks post randomization

    Subjects indicate their pain level by drawing a mark on a 10 cm line on a visual analog scale (VAS) at randomization and 4 week post treatment visit. The left end of the line indicates "no pain" and the right end of line indicates "worst pain imaginable". VAS score is determined by using a ruler placed at 0 (left end of scale) and measuring the distance from zero to the patient's mark . The objective is to compare the change in VAS values in MIST+SC to SC alone.

    H0: The average change in pain level is not different between MIST and SC HA: The average change in pain level is different between MIST and SC H0: µMIST = µSC vs HA: µMIST ≠ µSC,

    Statistical Analysis. A repeated measures ANCOVA will be used to test for differences in change in VAS with an indicator variable to indicate treatment, any demographic variables which were significant in the baseline comparisons.

Enrollment: 156
Study Start Date: April 2012
Study Completion Date: April 2015
Primary Completion Date: May 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
No Intervention: Standard of Care
30 to 40 mmHg compression, dressing for moist wound healing environment, debridement as needed. Minimum of one treatment per week and up to 3 times per week per investigator discretion for 4 weeks
Experimental: SOC + Mist Therapy
30 to 40 mmHg compression, dressing for moist wound healing environment, debridement as needed plus non-contract low frequency ultrasound 3 x per week for 4 weeks.
Device: MIST Therapy
Non-contact low frequency ultrasound therapy

Detailed Description:
The study compared the treatment effect of non-contact low frequency ultrasound in addition to standard of care versus standard of care alone in healing chronic venous leg ulcers in subjects who had documented venous stasis and reflux. Subjects that were screened and met the major inclusion criteria received standardized treatment of 30 to 40 mmHg compression, moist wound healing dressings, and debridement for a two week run-in period. If their study ulcer did not decreased by greater than 30% they were eligible for randomization. The primary endpoint was wound area reduction after four (4) weeks of study treatment. The study was performed at 22 study centers. The study included two sub-studies: fluid and tissue analysis and a wound recidivism registry that are ongoing.

Ages Eligible for Study:   18 Years to 90 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Lower extremity full thickness venous ulcer of > 30 days duration
  • Subject's wound must be between 4 cm² and 50 cm² at screening
  • Documented ABI that is between 0.8 and 1.2 on the study limb or transcutaneous partial pressure oxygen (TcpO2) > 40 mmHG; or a toe pressure > 40 mmHG; or a Doppler waveform consistent with adequate flow in the foot (biphasic or triphasic waveforms) at time of screening
  • Biopsy for wounds > 6 months duration
  • Documented index wound etiology of venous stasis with reflux and /or incompetent valves

Exclusion Criteria:

  • Index ulcer wound that is less than 1 cm in distance from another ulcer wound
  • > 5 ulcers on the index leg
  • Index ulcer wound has exposed tendons, ligaments, muscle, or bone
  • Index ulcer wound presents with clinical signs of acute infection, suspected or known
  • Subjects with evidence of osteomyelitis or cellulitis or gangrene in the study limb
  • Subjects with amputation above a Trans Metatarsal Amputation (TMA) in the study limb
  • Subjects with active malignancy on the study limb except non-melanoma skin cancer
  • Index ulcer that is of arterial disease etiology
  • Index ulcer of other primary etiology (ie. vasculitis, arterial, pyoderma)
  • Subjects with planned vascular surgery, angioplasty or thrombolysis procedures within the study treatment phase
  • Subjects with planned surgical procedure during the study treatment phase for the index wound including skin flap or skin graft
  • Subjects within 6 weeks postoperatively of a vascular o skin graft procedure.
  • Subject has had prior skin replacement, negative pressure therapy, or traditional ultrasound therapy applied to the index wound in the 14 days prior to screening
  • Subject has had ultrasound treatment (including MIST Therapy) of the index wound.
  • Subject has received growth factor therapy (e.g., autologous platelet-rich plasma gel, becaplermin, bilayered cell therapy, dermal substitute, extracellular matrix) within 14 days of screening date.
  • Subject is currently receiving or has received radiation or chemotherapy within 3 months of randomization.
  • Female subjects that are pregnant or refuse to utilize adequate contraceptive methods and are of childbearing age during the trial.
  • Subject has one or more medical condition(s), uncontrolled diabetes (i.e. HbA1c > 12), renal, hepatic, hematologic, neurologic, or immune disease that in the opinion of the investigator would make the subject an inappropriate study candidate
  • Subject's wound would require ultrasound near an electronic implant or prosthesis
  • Subject is known to be suffering from a disorder or other situation that the subject or investigator feels would interfere with compliance or other study requirements
  • Subject is currently enrolled or has been enrolled in the last 30 days in another investigational device or drug trial
  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT01549860

United States, Massachusetts
South Shore Hospital
Weymouth, Massachusetts, United States, 02189
Sponsors and Collaborators
Celleration, Inc.
Principal Investigator: Gary Gibbons, MD South Shore Hospital
Principal Investigator: Vicki Driver, DPM Providence RI
  More Information

No publications provided

Responsible Party: Celleration, Inc.
ClinicalTrials.gov Identifier: NCT01549860     History of Changes
Other Study ID Numbers: IN-BALANCE VLU
Study First Received: March 7, 2012
Results First Received: April 27, 2015
Last Updated: July 2, 2015
Health Authority: United States: Institutional Review Board

Keywords provided by Celleration, Inc.:
Venous Insufficiency
Lower Extremity Ulcer

Additional relevant MeSH terms:
Leg Ulcer
Varicose Ulcer
Venous Insufficiency
Cardiovascular Diseases
Pathologic Processes
Skin Diseases
Skin Ulcer
Varicose Veins
Vascular Diseases

ClinicalTrials.gov processed this record on November 25, 2015