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Trial of Dehydrated Human Amnion/Chorion Membrane (dHACM) In the Management of Diabetic Foot Ulcers

This study is currently recruiting participants. (see Contacts and Locations)
Verified January 2017 by MiMedx Group, Inc.
Information provided by (Responsible Party):
MiMedx Group, Inc. Identifier:
First received: September 19, 2012
Last updated: January 27, 2017
Last verified: January 2017
The objective of this study is to evaluate the percentage of patients with complete diabetic foot ulcer (DFU) closure following up to 12 weeks of treatment with either dehydrated human amnion/chorion membrane (dHACM) plus standard of care (SOC) or SOC alone.

Condition Intervention
Diabetic Foot Ulcer
Other: Standard of Care: Moist Wound Therapy and Offloading
Other: EpiFix plus Standard of Care

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: No masking
Primary Purpose: Treatment
Official Title: A Multicenter, Prospective, Randomized, Controlled, Comparative Parallel Study of Dehydrated Human Amnion/Chorion Membrane (dHACM) Wound Graft in the Management of Diabetic Foot Ulcers

Resource links provided by NLM:

Further study details as provided by MiMedx Group, Inc.:

Primary Outcome Measures:
  • Percentage of subjects with complete closure of the study ulcer [ Time Frame: Week 12 ]
    Assessed by the Investigator, during treatment (Visits 1 - 13).

Secondary Outcome Measures:
  • Time to complete closure for both groups [ Time Frame: Up to 12 Weeks ]
    As assessed by photographic evaluation and the Investigator

  • Rate of wound closure [ Time Frame: Up to Week 12 ]
    As assessed by photographic evaluation and the Investigator

  • Incidence of ulcer recurrence [ Time Frame: Up to Week 16 ]
    Incidence of ulcer recurrence at the site of the study ulcer during the follow up phase.

  • Quality of Life [ Time Frame: Up to Week 12 ]
    Change in quality of life metrics as measured by SF-36 Health Survey and changes in the patient's reported pain scores as measured by the Visual Analog Scale.

  • Cost effectiveness of treatment [ Time Frame: Up to Week 12 ]
    Cost effectiveness of treatment regimen.

Other Outcome Measures:
  • Safety [ Time Frame: Up to Week 16 ]
    The Safety population will be used for the analysis of safety endpoints.

Estimated Enrollment: 130
Study Start Date: July 2012
Estimated Study Completion Date: October 2017
Estimated Primary Completion Date: May 2017 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Standard of Care: Moist Wound Therapy and Offloading
Other: Standard of Care: Moist Wound Therapy and Offloading
Standard of Care: Moist Wound Therapy and Offloading
Experimental: EpiFix plus Standard of Care
Weekly application of EpiFix (up to 12 week) and standard of care (moist wound therapy and offloading)
Other: EpiFix plus Standard of Care
Weekly application of EpiFix and Standard of Care


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Male or female age 18 or older.
  2. The patient is willing and able to provide informed consent and participate in all procedures and follow up evaluations necessary to complete the study.
  3. Patient's ulcer must be diabetic in origin with a size ranging from 1 to 25 cm2. Debridement will be done prior to randomization, if clinically indicated.
  4. Wounds should be diabetic foot ulcers located on the dorsal or plantar surface of the foot.
  5. Patients with Type 1 or 2 diabetes (criteria for the diagnosis of diabetes mellitus per ADA).
  6. Ulcer must be present for a minimum of 30 days before enrollment/randomization, with documented failure of prior treatment to heal the wound (≤25% wound area reduction after 14 consecutive days of therapy immediately prior to randomization when treated with standard protocol of care).
  7. Affected leg has been offloaded (removable walker or total contact cast) for >14 consecutive days prior to randomization.
  8. Serum Creatinine less than 3.0mg/dl (within last 6 months).
  9. HbA1c less than 12% within previous 60 days.
  10. Patient has adequate circulation to the affected extremity, as demonstrated by one of the following within the past 60 days:

    • Dorsum transcutaneous oxygen test (TcPO2) with results ≥30mmHg, OR
    • ABIs with results of ≥0.7 and ≤1.2, OR
    • Doppler arterial waveforms, which are triphasic or biphasic at the ankle of affected foot.
  11. Females of childbearing potential must be willing to use acceptable methods of contraception (birth control pills, barriers, or abstinence).

Exclusion Criteria:

  1. Patients presenting with an ulcer probing to bone (UT Grade IIIA-D). A positive probe-tobone will be confirmed when bone or joint can be felt with a sterile, ophthalmological probe.
  2. Patients with multiple wounds on the same foot where other wounds are within 3 cm of the wound under care.
  3. Patients considered not in reasonable metabolic control, confirmed by an HbA1c 12% or greater at any time within previous 60 days.
  4. Known history of poor compliance with medical treatments.
  5. Patients currently enrolled in this study. Concurrent enrollment in the study is prohibited.
  6. Patients treated with investigational drug(s) or therapeutic device(s) within 30 days.
  7. Patients currently receiving radiation therapy or chemotherapy.
  8. Known or suspected local skin malignancy to the index diabetic ulcer.
  9. Patients diagnosed with autoimmune connective tissue diseases.
  10. Non-revascularizable surgical sites.
  11. Active infection at index site or currently being treated with antibiotics
  12. Any pathology that would limit the blood supply and compromise healing.
  13. Patients that have received a biomedical or topical growth factor for their wound within the previous 30 days. Study ulcer has been previously treated with tissue engineered materials (e.g. Apligraf® or Dermagraft®) or other scaffold materials (e.g. Oasis, Matristem) within the last 30 days.
  14. Patients who are known to be pregnant, plan to become pregnant, or are breast feeding.
  15. Known allergy to Gentamicin sulfate or Streptomycin sulfate.
  16. Active Charcot deformity or major structural abnormalities of the foot.
  17. Wounds that are greater than one year in duration without intermittent closure.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01693133

Contact: William Tettlebach, MD 801-507-9310

United States, Alabama
Central Research Associates, Inc. Recruiting
Birmingham, Alabama, United States, 35205
Contact: Bill Whitley    205-327-1077   
Principal Investigator: Jeffrey C Davis, MD         
United States, California
Stockdale Podiatry Group Completed
Bakersfield, California, United States, 93309
Center for Clinical Research Inc Recruiting
Castro Valley, California, United States, 94546
Contact: Alexander M Reyzelman, DPM    800-363-1069 ext 105   
Contact: Rozana Reyzelman    (800) 363-1069 ext 105   
Valley Vascular Surgery Associates Active, not recruiting
Fresno, California, United States, 93720
Limb Preservation Platform Active, not recruiting
Fresno, California, United States, 93721
Novak Urgent Care and Family Practice Completed
Indio, California, United States, 92201
Loma Linda VA Medical Center Completed
Loma Linda, California, United States, 92357
Foot & Ankle Clinic Recruiting
Los Angeles, California, United States, 90057
Contact: Felix Sigal, DPM    213-365-0793   
Contact: Maira Machado    (213)365-0793   
Palmtree Clinical Research, Inc. Completed
Palm Springs, California, United States, 92262
Center for Clinical Research, Inc. Recruiting
Sacramento, California, United States, 95628
Contact: Gregory Tovmassian, DPM    800-363-1069 ext 109      
Contact: Tayna Tovmassian    (800) 363-1069 ext 109   
Center for Clinical Research Recruiting
San Francisco, California, United States, 94115
Contact: Melissa Krueger    800-636-1069      
Principal Investigator: Alexander Reyzelman, DPM         
United States, Massachusetts
MetroWest Medical Center Completed
Framingham, Massachusetts, United States, 01702
South Shore Hospital Completed
Weymouth, Massachusetts, United States, 02190
United States, Ohio
Jobst Vascular Institute, Promedica Toledo Hospital Recruiting
Toledo, Ohio, United States, 43606
Contact: Joan Bick, RN, MSN    419-291-7182   
Principal Investigator: Steven Gale, MD         
United States, Oregon
Center for Clinical Research, Inc. Recruiting
Eugene, Oregon, United States, 97401
Contact: Lacey Loveland, DPM   
Contact: Robert Porter   
United States, South Carolina
Dorn VA Completed
Columbia, South Carolina, United States, 29209
United States, Texas
Futuro Clinical Trials, LLC Recruiting
McAllen, Texas, United States, 78501
Contact: Jessica Rodriguez    956-999-8399    RODRIGUEZCFFC@GMAIL.COM   
Principal Investigator: Joseph M Caporusso, DPM         
United States, Utah
IMC Wound Care Recruiting
Murray, Utah, United States, 84157
Contact: William Tettelbach, MD    801-507-9310      
Principal Investigator: William Tettelbach, MD         
LDS Hospital Recruiting
Salt Lake City, Utah, United States, 84143
Contact: William Tettelbach, MD    801-408-3638      
Principal Investigator: William Tettelbach, MD         
United States, Virginia
Coastal Podiatry, Inc. Recruiting
Virginia Beach, Virginia, United States, 23464
Contact: Kathleen McGee    757-523-0414   
Principal Investigator: Patrick S Agnew, DPM         
Sponsors and Collaborators
MiMedx Group, Inc.
Principal Investigator: William Tettelbach, MD Intermountain Medical Center
  More Information

Responsible Party: MiMedx Group, Inc. Identifier: NCT01693133     History of Changes
Other Study ID Numbers: EFDFU003 
Study First Received: September 19, 2012
Last Updated: January 27, 2017

Additional relevant MeSH terms:
Diabetic Foot
Foot Ulcer
Pathologic Processes
Diabetic Angiopathies
Vascular Diseases
Cardiovascular Diseases
Leg Ulcer
Skin Ulcer
Skin Diseases
Diabetes Complications
Diabetes Mellitus
Endocrine System Diseases
Diabetic Neuropathies
Foot Diseases processed this record on February 20, 2017