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Odor Management in Fungating Wounds Comparing Metronidazole and Polihexanide

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ClinicalTrials.gov Identifier: NCT02394821
Recruitment Status : Completed
First Posted : March 20, 2015
Last Update Posted : September 2, 2015
Sponsor:
Collaborator:
Fundação de Amparo à Pesquisa do Estado de São Paulo
Information provided by (Responsible Party):
DIANA LIMA VILLELA DE CASTRO, University of Sao Paulo

Brief Summary:

For odor control malignant wounds (MW), use is 0.8% metronidazole solution - second recommendation scientific and clinical practice. But no this formulation available in Brazil , and its application to nursing steeps metronidazole tablets , diluted in saline and applied to the bed of (MW) . Thus , it is used off label for metronidazole ( tablets orally applied via " topical " - but it is not intact skin or mucosa ) , nursing and eventually manipulate the solution at bedside , and by law this power is pharmacist bedside and can not be taken .

Family antiseptic chlorhexidine was developed with the purpose of use in infected wounds called polihexanide ( PHMB ) . In Brazil is now available for hospital and home care ( 0.2 % Aquasept ® ) use. Evidence reported positive results in controlling infection of chronic wounds such as pressure ulcers . Although not tested its efficacy in odor control. Thus the study aims to compare metronidazole solution 0.8 % versus 0.2 % PHMB in odor control , where , if the results are favorable to PHMB we have a treatment option in odor control with ready to use formulation and easy access . Evaluate and compare the effectiveness of metronidazole solution 0.8% and polihexanide solution (PHMB) in odor control in MW. Aims: Evaluate and compare the time needed for odor control (reduction in days), using metronidazole and PHMB in MW (primary endpoint); Evaluate and compare the perceptions of patients, nurses and researcher on the odor MW, using metronidazole and PHMB in the MW; Evaluate and compare the pain reported by patients during dressing changes, using metronidazole and PHMB in the MW; Evaluate and compare the quality of life of patients before and after the use of metronidazole and PHMB in MW. This is a randomized, double -blind study with patients diagnosed with cancer and patients with MW with odor clinical trial . The sample consisted of 24 subjects divided into 2 groups (control - metronidazole group and experimental group - PHMB ) , recruited in one cancer hospital in the city of São Paulo (AC Camargo Cancer Center), which has as protocol description in odor control MW metronidazole . After acceptance by the subject and return the Statement of Informed Consent signed , randomization will be done .

For blinding , 0.8 % metronidazole solution will be provided by a compounding pharmacy (after stability testing of tablet diluted - and then stipulated expiration date) , and PHMB be bought from the supplier , delivered to the same compounding pharmacy which stores the PHMB in identical bottles to metronidazole ( only the responsible researcher will know to which group the subject was randomized ) .

The evaluation of the odor will be taken by 3 " employees " and the patient through 3 scales at zero , four, eight and twelve days ( or earlier if classified as " odorless " by 3 reviewers and the patient ) . Two scales about painful sensations in exchange for healing , one on quality of life will be applied to the patient and a specifically on the impact of odor on the subject's life.

To meet the proposed objectives, the data will be analyzed by: Friedman test to assess the odor reduction with respect to time; Mann-Whitney (or t test) for comparison of groups and the Fisher exact test to compare proportions. Data will be presented in the form of frequency tables for categorical variables and means, standard deviations and position measurements for quantitative variables. Will also be performed non-parametric analysis of ordinal data, or parametric analysis with Generalized Estimation Equation for binomial variables, depending on the data distribution and the sample size.


Condition or disease Intervention/treatment Phase
Neoplasm Wounds and Injuries Drug: Polihexanide 2% Drug: Metronidazole 0.8% Phase 3

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 24 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Supportive Care
Official Title: Odor Management in Fungating Wounds Comparing Metronidazole and Polihexanide: Randomized Clinical Trial
Study Start Date : September 2013
Actual Primary Completion Date : July 2014
Actual Study Completion Date : September 2015

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Metronidazole
metronidazole 0.8% solution - topical
Drug: Metronidazole 0.8%
Experimental: Polihexanide
Polihexanide 2%
Drug: Polihexanide 2%



Primary Outcome Measures :
  1. Evaluate and compare the effectiveness of metronidazole solution 0.8% and polihexanide solution (PHMB) in odor control in malignant wounds. (odor scales) [ Time Frame: 30/12/2014 (up to 1 year) ]

Secondary Outcome Measures :
  1. To evaluate and compare the time required for odor control (reductions in days), using metronidazole and PHMB in malignant wounds (Friedman test to assess the odor reduction with respect to time) [ Time Frame: 30/12/2014 (up to 1 year) ]

Other Outcome Measures:
  1. Evaluate and compare the perceptions of patients, nurses and researcher on the odor in malignant wounds, using metronidazole and PHMB in malignant wounds; (evaluation of odor scales [painful sensations in exchange for healing , and quality of life]) [ Time Frame: 30/12/2014 (up to 1 year) ]


Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Age ≥ 18 years.
  • Diagnosis of malignat wound with odor, regardless of location, etiology and tumor staging; well as in treatment or palliative care.
  • Confirmation of participation in the study by signing the Instrument of Consent, personally or through responsible caretaker

Exclusion Criteria:

  • not smell

Information from the National Library of Medicine

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): NCT02394821


Locations
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Brazil
EEUSP
São Paulo, Brazil, 01509-900
Sponsors and Collaborators
University of Sao Paulo
Fundação de Amparo à Pesquisa do Estado de São Paulo
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Responsible Party: DIANA LIMA VILLELA DE CASTRO, ODOR MANAGEMENT IN FUNGATING WOUDS WITH METRONIDAZOLE versus PHMB: DOUBLE-BLINDED, RANDOMIZED, CLINICAL TRIAL, University of Sao Paulo
ClinicalTrials.gov Identifier: NCT02394821    
Other Study ID Numbers: EE-USP5571275
First Posted: March 20, 2015    Key Record Dates
Last Update Posted: September 2, 2015
Last Verified: September 2015
Additional relevant MeSH terms:
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Wounds and Injuries
Metronidazole
Polihexanide
Anti-Infective Agents
Anti-Bacterial Agents
Antiprotozoal Agents
Antiparasitic Agents
Disinfectants