Enzymatic Debridement in Burns Patients: A Comparison to Standard of Care
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Purpose
Burns represent one of the most severe and dreaded traumas. Burned and traumatized tissue is known as eschar. The dead eschar, if not removed, often becomes heavily contaminated and is the source of local and/or systemic infection or sepsis. The local inflammation and infection destroy healthy surrounding tissues and extends the original damage. In order to prevent these complications, and in order to minimize the risk of infection, it is imperative to evaluate the burn and remove all of the offending eschar at the earliest possible opportunity. This removal of dead tissue is termed "debridement".
The most direct debridement method for eschar removal is surgery. Traditional, conservative non-surgical debridement is a lengthy process which often involves many complications.
The objective of this study is to evaluate the safety and enzymatic debriding efficacy of Debrase Gel Dressing (DGD) in hospitalized patients with deep partial thickness and/or full thickness thermal burns and to compare DGD to standard of care (SOC).
| Condition | Intervention | Phase |
|---|---|---|
|
Burn |
Drug: DGD |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Enzymatic Debridement in Burns Patients (Children & Adults): A Comparison to Standard of Care (Protocol MW 2004-11-02) |
- Co-primary: % treated wound excised (by tangential/minor/Versajet excision) or dermabrasion, in first surgery, of deep partial wounds [ Time Frame: Surgical excision/dermabrasion performed as initial debridement (surgical SOC group) or as first post-debridement procedure (DGD or non-surgical SOC groups) ] [ Designated as safety issue: No ]
- Co-primary: % treated wound autografted of deep partial wounds [ Time Frame: Post-debridement autografts ] [ Designated as safety issue: No ]
- % treated wound excised (by tangential/minor/Versajet excision) or dermabrasion, in first surgery, for all wounds [ Time Frame: As for primary endpoint ] [ Designated as safety issue: No ]
- Time to complete wound closure [ Time Frame: % epithelialization assessed post-debridement at weekly intervals until all a patient's wounds closed ] [ Designated as safety issue: No ]
- Timely eschar removal [ Time Frame: Debridement procedures ] [ Designated as safety issue: No ]
- Blood loss [ Time Frame: Throughout study ] [ Designated as safety issue: Yes ]
| Enrollment: | 182 |
| Study Start Date: | December 2005 |
| Study Completion Date: | February 2010 |
| Primary Completion Date: | October 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: DGD |
Drug: DGD
Lyophilized, sterile mixture of proteolyzed enzymes; mixed with gel,for topical application.
|
| Active Comparator: SOC |
Drug: DGD
Lyophilized, sterile mixture of proteolyzed enzymes; mixed with gel,for topical application.
|
Detailed Description:
Completed study.
Eligibility| Ages Eligible for Study: | 4 Years to 55 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Males and females between 4 years to 55 years of age,
- Thermal burns caused by fire/flame, scalds or contact,
- Deep partial thickness (mixed deep dermal) and/or full thickness (3°) burn wounds ≥ 5% and ≤ 30% Total Body Surface Area (TBSA); all these wounds must receive study treatment,
- At least one wound of ≥ 2% TBSA deep partial thickness and/or full thickness burn,
- Total burn wounds ≤ 30% TBSA,
- Signed written informed consent.
Exclusion Criteria:
- Deep partial thickness and/or full thickness facial burn wounds, > 0.5% TBSA; study treatment of facial burns is not allowed,
- Study treatment of perineal and/or genital burns (A patient with these wounds may be enrolled but the wounds may not be designated as target wounds),
- Circumferential anterior/posterior trunk full thickness fire/flame burns, > 15% TBSA, (Circumferential is defined as encircling ≥ 80% of the trunk circumference.)
- Pre-enrollment escharotomy,
- Heavily contaminated burns or pre-existing infections,
- Signs that may indicate smoke inhalation,
- General condition of patient would contraindicate surgery,
- Pregnant women (positive pregnancy test) or nursing mothers,
- Poorly controlled diabetes mellitus (HbA1c>9%),
- Cardio-pulmonary disease (MI within 4 weeks prior to injury, pulmonary hypertension, COPD or pre-existing oxygen-dependent pulmonary diseases),
- Pre-existing diseases which interfere with circulation (PVD, edema, lymphedema, surgery to the regional lymph nodes, obesity, varicose veins),
- Immediate life threatening conditions (such as immuno-compromising diseases, life threatening trauma, severe pre-existing coagulation disorder, cardiovascular, liver or neoplastic disease),
Contacts and Locations| Australia, Western Australia | |
| Royal Hospital Perth | |
| Perth, Western Australia, Australia | |
| Brazil | |
| Pronto Socorro para Queimaduras de Goiania | |
| Goiania, Brazil | |
| Hospital do Servidor Publico do Estado de Sao Paulo | |
| Sao Paulo, Brazil | |
| France | |
| Centre Hospitalier Regional et Universitaire de Marseille, Service de Chirurgie Plastique Reparatrice et Esthetique | |
| Marseille, France, 13005 | |
| Center Des Brules Hopital Cochin | |
| Paris, France, F-75014 | |
| Germany | |
| Unfallkrankenhaus Berlin Burn Center | |
| Berlin, Germany | |
| BG - Unfallklinik Ludwigshafen | |
| Ludwigshafen, Germany | |
| Klinikum Mannheim Universtatsklinikum | |
| Mannheim, Germany | |
| Israel | |
| Soroka University Medical Center | |
| Beer Sheba, Israel | |
| Italy | |
| Centro Grandi Ustionati | |
| Cesena, Italy, 47023 | |
| Direttore U.O. Chirurgia Plastica e Centro Ustioni Ospedale Civico | |
| Palermo, Italy, 90127 | |
| Poland | |
| Wojskowy Instytut Medyczny | |
| Warsaw, Poland | |
| Romania | |
| Emergency Clinic Hospital "Bagdazar-Arsenie" | |
| Bucharest, Romania | |
| Slovakia | |
| Center for Burns & Reconstructive Surgery, University Hopsital Bratislava | |
| Bratislava, Slovakia, 82107 | |
| Clinic of Burns and Reconstructive Surgery Hospital Kosice | |
| Kosice-Saca, Slovakia, 04015 | |
| United Kingdom | |
| Queen Victoria Hospital | |
| East Grinstead, United Kingdom, RH19 3DZ | |
| The Burn Center Pinderfields Hospital | |
| Wakefield, United Kingdom, WF1 4EE | |
| Study Chair: | Lior Rosenberg, MD | MediWound Ltd |
More Information
Publications:
| Responsible Party: | Siyu Liu, Vice President, North American Innovative Research & Development and Head of Global Clinical Operations ), Teva Neuroscience |
| ClinicalTrials.gov Identifier: | NCT00324311 History of Changes |
| Other Study ID Numbers: | MW2004-11-02 |
| Study First Received: | May 10, 2006 |
| Last Updated: | May 8, 2011 |
| Health Authority: | United Kingdom: Medicines and Healthcare Products Regulatory Agency Israel: Ministry of Health |
Additional relevant MeSH terms:
|
Burns Wounds and Injuries |
ClinicalTrials.gov processed this record on June 13, 2013