Enhanced Ultrasound Treatment of Chronic Wounds With Monitoring of Healing and Quality of Life Outcomes
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|ClinicalTrials.gov Identifier: NCT03041844|
Recruitment Status : Recruiting
First Posted : February 3, 2017
Last Update Posted : July 24, 2020
|Condition or disease||Intervention/treatment||Phase|
|Diabetic Foot Ulcer Venous Ulcer||Device: Low Frequency, Low Intensity Ultrasound Device: Sham Applicator||Not Applicable|
The two most common types of chronic wounds are venous ulcers (VUs) and diabetic ulcers (DUs). The investigators will conduct the first double-blind randomized controlled trial (RCT) to test the effect of low-frequency, low-intensity (LFLI) ultrasound (US) on chronic wound healing and health related quality of life (HRQOL) with high statistical confidence (α < 0.05, power > 0.90, n=60 VUs, n=60 DUs). The investigators' approach combines this active therapy with non-invasive diagnostic monitoring of wound hemodynamics throughout the treatment cycle, and includes analysis of the impact of nutritional status and inflammation on wound closure. There are several innovative aspects of this work. Specifically, (1) The lightweight, battery-powered applicator is the first potentially wearable ultrasound wound therapy device that is safe to apply for extended periods of time. (2) The applicator actively promotes healing, which is fundamentally different from commercial ultrasonic systems that remove necrotic tissue only. (3) The study approach will link LFLI US exposure to changes in wound hemodynamics and HRQOL, which has the potential to enable personalized medicine. (4) The analysis of patient nutritional and systemic inflammatory status may enable further treatment customization by identifying those patients most likely to benefit from LFLI US therapy. (5) The study approach incorporates both disease-specific and generic measures of HRQOL, which is unique for a therapeutic ultrasound RCT.
The low-frequency, low-intensity (20 kiloHertz (kHz), <100 milliWatt per square centimeter (mW/cm2) spatial peak-temporal peak), portable ultrasound applicator is lightweight (<25g) and permits safe and clinically pragmatic wound treatment. The field parameters of the US device were previously optimized for venous ulcers, and three recent pilot clinical human studies (VUs: n=20, n=25; DUs: n=10) demonstrated that the treatment improved healing by 15% per week compared to sham treatment. The investigators therefore anticipate that our treatment will accelerate closure of chronic wounds, and hypothesize that (1) LFLI US will improve generic and disease-specific HRQOL scores, (2) LFLI US will activate beneficial changes in the microvasculature of the wound and surrounding tissue, and (3) individuals with poor nutrition and high levels of inflammation will have delayed wound healing.
The specific aims are to: (1) Assess the effect of LFLI US on VUs and DUs by measuring wound closure as a primary endpoint and generic and disease-specific HRQOL as secondary endpoints. (2) Monitor the effects of LFLI US on wound perfusion and oxygenation using non-invasive optical methods, and (3) Determine the impact of nutritional status and inflammation on closure of DUs and VUs. Overall, this work will validate LFLI US as a safe, portable, and cost-effective therapy for chronic wounds. This is important because new therapies and improved clinical paradigms for wound management are urgently needed. Over the long-term, the study findings may enable the development of personalized wound treatment regimens across care settings.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||120 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)|
|Study Start Date :||January 2017|
|Estimated Primary Completion Date :||August 2021|
|Estimated Study Completion Date :||September 2021|
Experimental: Low Frequency, Low Intensity Ultrasound
Low Frequency, Low Intensity therapeutic ultrasound applied weekly for up to 16 weeks.
Device: Low Frequency, Low Intensity Ultrasound
Therapeutic ultrasound (20 kHz, <100 mW/cm2 spatial peak-temporal peak)
Sham Comparator: Sham Ultrasound
Sham ultrasound applied weekly for up to 16 weeks.
Device: Sham Applicator
Sham ultrasound applicator
- Change in wound size [ Time Frame: 4 weeks ]Percentage change in wound size over 4 weeks
- Wound closure [ Time Frame: 16 weeks ]Complete wound closure at 16 weeks
- Health Related Quality of Life (HRQOL) [ Time Frame: 16 weeks, then 6 and 12 months after last treatment ]Short form health survey will be administered to assess changes in HRQOL
- Wound Quality of Life (WQOL) [ Time Frame: 16 weeks ]Health survey will be administered to assess changes in wound-related HRQOL
- Wound oxyhemoglobin concentration change [ Time Frame: 16 weeks ]Change in wound oxyhemoglobin concentration per week, measured with diffuse near infrared spectroscopy (DNIRS)
- Microcirculatory blood flow index change [ Time Frame: 16 weeks ]Change in microcirculatory blood flow index per week, measured with diffuse correlation spectroscopy (DCS)
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): NCT03041844
|Contact: Michael S Weingarten, MD||215-762-7008||Michael.Weingarten@drexelmed.edu|
|United States, Pennsylvania|
|Drexel University College of Medicine||Recruiting|
|Philadelphia, Pennsylvania, United States, 19102|
|Contact: Michael S Weingarten, MD 215-762-7008 Michael.Weingarten@drexelmed.edu|
|Temple University School of Podiatric Medicine||Recruiting|
|Philadelphia, Pennsylvania, United States, 19107|
|Contact: James McGuire, DPM 215-625-5387 firstname.lastname@example.org|
|Principal Investigator:||Peter A Lewin, PhD||Drexel University|