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Protocol was withdrawn and closed by IRB in April, 2018 prior to enrollment of first patient
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| Name | Class |
|---|---|
| Shriners Hospitals for Children | OTHER |
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Frozen Human Cadaver Allograft (FHCA) is, nowadays, the gold standard for temporary coverage of excised full-thickness burns, but is also very expensive and requires additional personnel and major storage spaces in comparison to other products. The purpose of this study is to determine the extent to which PermeaDerm® dressing promotes wound bed maturation when used as a temporary dressing for excised full-thickness burn wounds. Efficacy and safety in promoting wound bed maturation for successive autografting will be determined through direct comparison to FHCA.
In this prospective, randomized, matched design pilot study, we aim to compare the current standard of care FHCA to PermeaDerm®.
30 patients for each study arm (n total = 60) meeting the inclusion criteria will be enrolled to randomly receive FHCA and PermeaDerm® on two adjacent or symmetric body areas.
Prior to randomization of study areas and application of study dressings, baseline assessments of wound size and burn depth will be performed by the experienced physician and documented using photography and when indicated laser Doppler (Moor Laser Speckle®, Moor Instruments, Devon, UK) measurements. Percentage of graft take and wound healing after removal of the temporary wound dressings and secondary autografting (study arm 1) or after excision and direct autografting with wiedely-meshed autograft and temporary wound dressings as overlay (study arm 2) will be assessed.
Secondary outcomes will include complications such as infections, signs of rejection/non-adherence, fluid accumulation/hematoma beneath dressings and mid- and long-term clinical scar maturation, as assessed by the POSAS and objectively with the DermaLab Combo® device (Cortex Technology ApS, Hadsund, Denmark).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Permeaderm as temporary coverage | Experimental | A: temporary coverage with PermeaDerm until autografting: After randomization of study site, study dressing will be applied as temporary coverage on freshly excised full-thickness burn wounds. |
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| FHCA as temporary coverage | Active Comparator | B: temporary coverage with FHCA until autografting: After randomization of study site, study dressing will be applied as temporary coverage on freshly excised full-thickness burn wounds. |
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| Permeaderm over widely meshed autograft | Experimental | C: temporary coverage of widely meshed autograft with PermeaDerm until healing occurs and PermeaDerm can remove |
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| FHCA over widely meshed autograft | Active Comparator | D: temporary coverage of widely meshed autograft with FHCA until healing occurs |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PermeaDerm for temporary coverage | Device | See above |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Time to heal | Time until study areas are 95% healed, as rated by blinded assessors based on photographs | up to 8 weeks after initial grafting |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of adherence problems (Arm 2) | % of non-adherence at first dressing change | up to 21 days after initial surgery |
| Incidence of adherence problems (Arm 1) | % of non-adherence at first dressing change and at time of dressing removal before grafting |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| David N Herndon, MD | The University of Texas Medical Branch, Galveston | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of texas Medical Branch Galveston | Galveston | Texas | 77555 | United States |
data won't be shared
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Randomized matched design with application of both study dressings symmetrical or adjacent body sites at the same time.
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Outcomes assessors (healing time and scar assessments) are blinded.
| FHCA for temporary coverage |
| Device |
See above |
|
| PermeaDerm over autograft | Device | See above |
|
| FHCA over autograft | Device | see above |
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| up to 21 days after initial surgery |
| Incidence of infections | Incidence of infection, defined as >10x5 bacteria/g tissue, Only taken when infection suspected. | up to 8 weeks after initial grafting |
| Rate of fluid/hematoma accumulation | % of fluid accumulation/hematoma formation at first dressing change | up to 21 days after initial surgery |
| Cost effectiveness | Price per cm square of each study dressing | Until grafting of study sites, within 21 days |
| Scar assessment with Patient and Observer Assessment Scale (POSAS) | Using Patient and Observer Scar Assessment Scale POSAS, what is a composite score that is rating the overall appearance of the scar, based on each single score for rating vascularity, pigmentation, thickness, relief, pliability, surface. Every subscore ranges from 1-10. The composite score is calculated as an average of the subscores. Higher numbers mean worse scarring. | Assessed within 4 weeks after 95% wound healing |
| Scar assessment with Patient and Observer Assessment Scale (POSAS) | Using Patient and Observer Scar Assessment Scale POSAS, what is a composite score that is rating the overall appearance of the scar, based on each single score for rating vascularity, pigmentation, thickness, relief, pliability, surface. Every subscore ranges from 1-10. The composite score is calculated as an average of the subscores. Higher numbers mean worse scarring. | Assessed between 3 and 9 months after initial admission |
| Scar assessment with Patient and Observer Assessment Scale (POSAS) | Using Patient and Observer Scar Assessment Scale POSAS, what is a composite score that is rating the overall appearance of the scar, based on each single score for rating vascularity, pigmentation, thickness, relief, pliability, surface. Every subscore ranges from 1-10. The composite score is calculated as an average of the subscores. Higher numbers mean worse scarring. | Assessed between 9-15 months after initial admission |
| Scarring with DermaLab Combo device: Viscoelasticity | Measured through negative suction and retraction time. | Assessed within 4 weeks after 95% wound healing |
| Scarring with DermaLab Combo device: Viscoelasticity | Measured through negative suction and retraction time. | Assessed between 3 and 9 months after initial admission |
| Scarring with DermaLab Combo device: Viscoelasticity | Measured through negative suction and retraction time. | Assessed between 9-15 months after initial admission |
| Scarring with DermaLab Combo device: Hydration | Measured based on skin conductance. | Assessed within 4 weeks after 95% wound healing |
| Scarring with DermaLab Combo device: Hydration | Measured based on skin conductance. | Assessed between 3 and 9 months after initial admission |
| Scarring with DermaLab Combo device: Hydration | Measured based on skin conductance. | Assessed between 9-15 months after initial admission |
| Scarring with DermaLab Combo device: Pigmentation | Measured based on light absorption of melanin and erythema | Assessed within 4 weeks after 95% wound healing |
| Scarring with DermaLab Combo device: Pigmentation | Measured based on light absorption of melanin and erythema | Assessed between 3 and 9 months after initial admission |
| Scarring with DermaLab Combo device: Pigmentation | Measured based on light absorption of melanin and erythema | Assessed between 9-15 months after initial admission |
| Scarring with DermaLab Combo device: Trans epithermal water loss | Measuring evaporation in g/meter square/hour | Assessed within 4 weeks after 95% wound healing |
| Scarring with DermaLab Combo device: Trans epithermal water loss | Measuring evaporation in g/meter square/hour | Assessed between 3 and 9 months after initial admission |
| Scarring with DermaLab Combo device: Trans epithermal water loss | Measuring evaporation in g/meter square/hour | Assessed between 9-15 months after initial admission |