Nerve Decompression for Ulcer Recurrence Avoidance (DURA) (DURA)
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|ClinicalTrials.gov Identifier: NCT01762085|
Recruitment Status : Unknown
Verified June 2015 by Association of Extremity Nerve Surgeons.
Recruitment status was: Recruiting
First Posted : January 7, 2013
Last Update Posted : June 26, 2015
|Condition or disease||Intervention/treatment|
|Diabetic Ulcer of Plantar Aspect of Left Foot Diabetic Ulcer of Plantar Aspect of Right Foot Diabetic Polyneuropathy||Procedure: nerve decompression|
Diabetes patients with a recently healed, non-ischemic plantar diabetic foot ulcer will be randomized to "best care" standard post-ulcer treatment or to best care plus bilateral nerve decompression by external neurolysis at 4 fibro-osseous tunnel sites in the leg and foot. Comparison of the control group with standard care to the surgical intervention group will be made for subsequent appearance of a plantar foot ulcer and ulcer recurrence risks will be calculated. Additional subjective and objective secondary outcomes will be monitored. Null hypothesis: nerve decompression will not decrease diabetic foot ulcer recurrence risk.
If protection against ulcer occurrence were to be confirmed, a change in the treatment paradigm for diabetic neuropathy and foot ulcer could be appropriate.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||120 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||None (Open Label)|
|Official Title:||A Prospective Study of Recurrence Risk in Diabetic Foot Ulceration After Nerve Decompression|
|Study Start Date :||June 2013|
|Estimated Primary Completion Date :||December 2016|
|Estimated Study Completion Date :||December 2016|
Placebo Comparator: healed DFU control arm
clinic-specific usual "best care"
Experimental: healed DFU surgical intervention
clinic-specific "best care" plus nerve decompression at 4 known sites of lower leg fibro-osseous entrapment
Procedure: nerve decompression
surgical decompression involves surgical division or incision of perineural fibrous or fibro-osseous tunnel tissues which pinch, choke, compress or sharply deviate nerve trunks.
- occurrence of plantar foot ulceration wound [ Time Frame: 2 years post-enrollment or post-op ]Non- traumatic pressure wound or ulcer appearance during the study.
- occurrence of delayed wound healing [ Time Frame: 3 months post nerve decompression ]failure of surgical wound to heal primarily, without local infection signs of swelling, heat, redness, and pain
- Visual Analog Pain Score [ Time Frame: 2 years ]Patient report of pain level
- any amputation [ Time Frame: 24 months, 2 years ]surgical removal of any part of the lower extremity, including toe
- surgical wound infection [ Time Frame: 3 months ]swelling, redness, or heat, with pain after surgery
- non-surgical foot infection [ Time Frame: 24 months ]foot swelling, redness, pain, and heat not subsequent to operation; or occurring in an operated leg >90 days post-op
- measures of diabetic peripheral neuropathy (DPN) [ Time Frame: 2 years ]Michigan Neuropathy Symptom Index; Pain visual analog pain scale (VAPS); sensibility to vibration, light touch, 2-point discrimination; deep tendon reflex
- analgesic usage [ Time Frame: 2 years ]patients will log use of analgesic medications and changes in use.
- SPY Indocyanine green circulation evaluation [ Time Frame: pre-opo, post-op, study end ]This intravenous injection and non-invasive scan evaluation may indicate whether relief of nerve entrapment will alter macro or microcirculation
- Incidence of falls during the study [ Time Frame: 2 years ]Prior history of falls will be defined and changes in risk of new falls in control and intervention groups. Balance has been reported to improve after nerve decompression.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01762085
|Contact: Stephen Barrett, DPM||623 email@example.com|
|Contact: D. Scott Nickerson, MD||307 firstname.lastname@example.org|
|United States, Arizona|
|Barrett Foot & Ankle Institute||Recruiting|
|Phoenix, Arizona, United States, 85024|
|Contact: Steven L Barrett, DPM 480-478-0780 email@example.com|
|Contact: John C Tassone, DPM (602) 938-6960 firstname.lastname@example.org|
|Principal Investigator: Stephen L Barrett, DPM|
|Richard P. Jacoby||Recruiting|
|Scottsdale, Arizona, United States, 85251|
|Contact: Richard P Jacoby, DPM 480-994-5977 email@example.com|
|Principal Investigator: Richard P Jacoby, DPM|
|Southern Arizona Limb Salvage Alliance,||Recruiting|
|Tucson, Arizona, United States, 85724-5072|
|Contact: Manish Bharara, PhD 520-626-1349 firstname.lastname@example.org|
|Contact: David Armstrong, DPM (520) 626-1349|
|Principal Investigator: Manish Bharara, PhD|
|United States, Indiana|
|Andrew Rader, DPM||Recruiting|
|Jasper, Indiana, United States, 47546|
|Contact: Andrew P Rader, DPM 812-634-2778 email@example.com|
|Principal Investigator: Andrew P Rader, DPM|
|United States, Texas|
|Denton, Texas, United States, 76210|
|Contact: Damien Dauphinee, DPM 940-300-3054 firstname.lastname@example.org|
|Principal Investigator: Damien Dauphinee, DPM|
|Maria Buitrago, DPM||Recruiting|
|Houston, Texas, United States, 77092|
|Contact: Maria Buitrago, DPM 713-680-3668 email@example.com|
|Principal Investigator: Maria Buitrago, DPM|
|Study Director:||D. Scott Nickerson, MD||NE Wyoming Wound Care Center, consultant|
|Principal Investigator:||Stephen L. Barrett, DPM||Barrett Foot & Ankle Institute|