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Prevention of Infection Using a Topical Gentamicin-Collagen Sponge in Diabetic Patients With An Uninfected Foot Ulcer

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00658957
Recruitment Status : Terminated (Business Decision)
First Posted : April 16, 2008
Last Update Posted : March 23, 2012
Premier Research Group plc
Information provided by (Responsible Party):

Brief Summary:
The purpose of this study is to determine the safety and efficacy of the topical gentamicin collagen sponge (gentamicin sponge) combined with standard of care (daily wound care, off-loading, diabetic control and debridement by a physician or podiatrist), compared with placebo sponge combined with standard of care, in preventing infection of diabetic lower extremity skin ulcers.

Condition or disease Intervention/treatment Phase
Diabetic Foot Ulcer Drug: gentamicin-collagen sponge Drug: placebo collagen sponge Phase 2

Detailed Description:

Infected skin ulcers with diabetes can be very debilitating because they are difficult to heal. Diabetic ulcers are responsible for frequent health care visits, and are a major predictor of amputation. Diabetic ulcers can be caused by a patient's inability to sense pain or warmth as well as peripheral vascular disease, which causes diminished blood flow to the foot. Early aggressive treatment is necessary to prevent infection and ultimately prevent the need for amputation.

Gentamicin is an antibiotic that is effective in treating certain kinds of infection. Collagen is a protein that is found in all mammals. The gentamicin-collagen sponge is a thin flat sponge made out of collagen that comes from cow tendons and containing gentamicin. When applied to an open ulcer, the collagen breaks down and the gentamicin is released into the ulcer, but very little is absorbed into the blood stream. The high levels of gentamicin in the open infected ulcer may help treat the infection.

In this study, all subjects will be given the necessary supplies and taught how to take care their foot ulcer. Subjects will be randomly assigned to receive either the gentamicin-collagen sponge or a plain collagen sponge. The sponge will be applied into the ulcer twice a week during the treatment period.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 49 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Prevention
Official Title: A Phase II, Randomized, Parallel, Double-blind, Placebo-controlled Study to Assess Prevention of Infection Using a Topical Gentamicin-Collagen Sponge in Diabetic Patients With Uninfected Lower Extremity Skin Ulcers
Study Start Date : April 2008
Actual Primary Completion Date : October 2009
Actual Study Completion Date : October 2009

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Foot Health

Arm Intervention/treatment
Experimental: A
Daily standard wound care and topical application of the gentamicin-collagen sponge twice weekly
Drug: gentamicin-collagen sponge
5 × 5 cm sponge
Other Name: Collatamp G

Placebo Comparator: B
Daily standard wound care and topical application of the placebo sponge twice weekly
Drug: placebo collagen sponge
5 × 5 cm sponge

Primary Outcome Measures :
  1. The percentage of patients who remain free of signs and symptoms of infection until the end of the study [ Time Frame: Up to 3 months ]

Secondary Outcome Measures :
  1. Time (days) to complete wound closure [ Time Frame: Actual time ]
  2. Time (days) to presence of ≥ 1 of the signs and symptoms of infection [ Time Frame: Actual time ]
  3. Absolute and percent decrease in total wound surface area [ Time Frame: End of Study ]
  4. Pathogen burden in patients who discontinue because of infection [ Time Frame: Throughout study period ]
  5. Treatment emergent Adverse Events [ Time Frame: Throughout study period ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Is a man or woman aged ≥ 18 and ≤ 80 years.
  • Has diabetes mellitus according to the American Diabetes Association criteria.
  • Has a single skin ulcer below the knee, defined as "uninfected" by the Infectious Disease Society of America Guidelines (Wound lacking purulence or any manifestations of inflammation).
  • Has had an x-ray of the affected area within the 2 days immediately preceding or at Visit 1 (Baseline/Randomization) that is negative for osteomyelitis.
  • Has an ankle-brachial index (ABI) ≥ 0.7 and ≤ 1.3. (Note: Patients with ABI < 0.7 or > 1.3 may be included if they have either a transcutaneous oxygen pressure or a toe pressure ≥ 40 mm Hg on the limb with the target ulcer.)
  • Meets certain minimal laboratory criteria.
  • If female, is nonpregnant (negative pregnancy tests at the Baseline/Randomization Visit) and nonlactating.
  • If female, is either not of childbearing potential (defined as postmenopausal for at least 1 year or surgically sterile [bilateral tubal ligation, bilateral oophorectomy, or hysterectomy]) or practicing 1 of the following medically-acceptable methods of birth control and agrees to continue with the regimen throughout the study:

Oral, implantable or injectable contraceptives for 3 consecutive months before the Baseline/Randomization Visit.

Total abstinence from sexual intercourse (minimum of 1 complete menstrual cycle before the Baseline/Randomization Visit).

Intrauterine device (IUD). Double barrier method (condoms, sponge, diaphragm or vaginal ring with spermicidal jellies or cream).

  • Willing to return to the study facility for the Posttreatment Evaluation Visit.
  • Must be able to fluently speak and understand English and be able to provide meaningful written informed consent for the study.

Exclusion Criteria:

  • Has a known history of hypersensitivity to gentamicin (or other systemic aminoglycosides) or any of the test article or reference product components.
  • Has a known hypersensitivity to bovine collagen.
  • Has any uncontrolled illnesses that, in the opinion of the Investigator, would interfere with interpreting the results of the study.
  • Has a target ulcer with a wound size > 5 × 5 cm.
  • Has gangrene or infection of the affected limb.
  • Has a wound associated with prosthetic material or device.
  • Received any topical or systemic antimicrobial therapy within the 2 weeks prior to study entry (Visit 1 [Day 1]).
  • Has documented osteomyelitis.
  • If severely immunocompromised, may be excluded at the discretion of the Investigator.
  • Has a history of alcohol or substance abuse in the past 12 months.
  • Is undergoing dialysis (renal or peritoneal) or has history of kidney transplant.
  • Has history of myasthenia gravis or other neurological condition where gentamicin use is contraindicated as determined by the Investigator.

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 identifier (NCT number): NCT00658957

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United States, Maryland
Chesapeake Foot and Ankle Center
Pasadena, Maryland, United States, 21122
Sponsors and Collaborators
Premier Research Group plc
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Study Director: David Prior Innocoll
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Responsible Party: Innocoll Identifier: NCT00658957    
Other Study ID Numbers: INN-TOP-002
First Posted: April 16, 2008    Key Record Dates
Last Update Posted: March 23, 2012
Last Verified: March 2012
Keywords provided by Innocoll:
Foot Ulcer
Additional relevant MeSH terms:
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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
Anti-Bacterial Agents
Anti-Infective Agents
Protein Synthesis Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action