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OBJECTIVES: Main objective: To evaluate the effectiveness of plasma rich in growth factors (PRGF) in the treatment of patients with venous ulcers. Secondary objective: To evaluate the safety of plasma rich in growth factors in treating patients with venous ulcers. DESIGN: Randomized, open clinical trial in parallel groups, controlled with conventional treatment.
SAMPLE: Over age patients, of primary care centers of Vitoria, with at least one venous ulcers of 6 or more weeks of evolution and 0.5-6 cm of diameter. INTERVENTION: 1-Experimental group: Autologous PRGF administrated once a week (day 1) + conventional treatment administrated twice a week (days 1 and 4)for 12 weeks of treatment, but in those cases where there has been no complete healing in this period, patients will continue the same management protocol to get it. 2-Control group: Conventional treatment twice a week (days 1 and 4)for 12 weeks of treatment.
Conventional treatment includes: Cleaning and debridement of the wound, the application of corresponding dressing, and using of antibiotic if necessary in each visit.
STATISTICAL ANALYSIS:The primary outcome analysis was done by logistic regression. The crude model and the adjusted model (for confounding variables)will be built. The healing time of ulcers (in days) were analyzed using the Kaplan Meier survival analysis and the corresponding comparison using the log rank test.
An open, randomized, of parallel groups, and controlled clinical trial. Patients will be allocated on first come to one of the two treatment groups using a block random sequence generated by computer that will remain hidden from the researchers and patients until allocation.
Experimental group: PRGF together with the corresponding dressing according to annex IV.
Control group: Corresponding dressing according to annex IV.
Both groups will be submitted to a cleaning, debridement, occlusive dressing and use of antibiotic if necessary in each visit.
After signing consent form, and previously of randomization, patients will be submitted to a blood extraction where it will be determinate: Albumine (in g/dl), Hemoglobin (in g/dl), Hematocrit (in %), Creatinine (in mg/dl). If patients have data collected through previous analysis performed until 30 days before, it will not be necessary a new extraction.
Patients will be also submitted to an initial valuation of:
Patients will go to the physician's consult every fours days (on Monday or Tuesday and Thursday or Friday). When one ulcer is closed, patient will go to physician's consult to confirm that it remains closed at seven and fifteen days.
In both intervention and control groups, the bad evolution of ulcer with deterioration at least during four consecutive weeks, will obligate to ask a preferred inter-consultation with Vascular Surgery Service.
In each visit the following variables will be measured:
If patient experience one adverse effect which according to judgment of nurse precludes its continuation into the study, the nurse will communicate it to physician who will discharge from study if it is necessary.
All this will be collected in Case Report Form (CRF).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PRGF and conventional treatment | Experimental | PRGF once a week (day 1) and conventional treatment twice a week (days 1 and 4) |
|
| Conventional treatment alone | Active Comparator | Conventional treatment (cleaning, debridement of the wound and application of the corresponding dressing and using of antibiotics if necessary) twice a week (days 1 and 4). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PRGF+ Cleaning, debridement of the wound, application of the corresponding dressing and using of antibiotics if necessary | Procedure | PRGF once a week (day 1) and conventional treatment twice a week (days 1 and 4)during 12 weeks. Types of dressing: enzyme cutting dressing (collagenase), hydrogel, polymeric foam, alginate dressing, hydrocolloid hydrofiber dressing, silver dressing, coal and silver dressing, argentum sulfadiazine dressing, polyurethane or caster hydrocolloid dressing |
| Measure | Description | Time Frame |
|---|---|---|
| Ulcers closed | Patients will be followed during 12 weeks. | at 12 weeks of treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Pruritus (Yes/No) | During 12 weeks of treatment (in each visit) | |
| Pain (through VAS scale) | During 12 weeks of treatment (in each visit) | |
| Signs of infection (Yes/No) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Javier Urraca | Contact | 945006669 | JAVIER.URRACAGARCIAMADINABEITIA@osakidetza.net |
| Name | Affiliation | Role |
|---|---|---|
| Javier Urraca | Basque Public Health Service-Osakidetza | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Javier Urraca García de Madinabeitia | Vitoria-Gasteiz | Álava | Spain |
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|
| Cleaning, debridement of the wound, application of the corresponding dressing and using of antibiotics if necessary | Procedure | Twice a week (days 1 and 4) during 12 weeks |
|
| During 12 weeks of treatment (in each visit) |
| Wound surface (in cm2) measured through PUSH scale | Every 4 days |
| ID | Term |
|---|---|
| D014647 | Varicose Ulcer |
| ID | Term |
|---|---|
| D014648 | Varicose Veins |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D007871 | Leg Ulcer |
| D012883 | Skin Ulcer |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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