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This is a randomized, sham-controlled pilot study that will assess the safety and feasibility of splenic focused pulsed ultrasound treatment on burn wound healing time in 24 subjects (12 active ultrasound and 12 sham controls).
The Central Hypothesis underlying this study is that splenic ultrasound stimulation activates the splenic anti-inflammatory pathway, thereby producing reduction in circulating macrophage cytokine production, reduction of neutrophil invasiveness, or induction of phenotypic transition in circulating immune cells (e.g., M1 to M2 transition in macrophages) in patients with partial thickness wounds that cover <20% body surface area.
Approximately 24 subjects will participate in this study. Male and female subjects of all races and ethnicities will be recruited for study from the ethnically diverse patient population of the LAC+USC Burn Center from the surrounding area.
Phase 0
Burn wound subjects will be screened and enrolled at the LAC+USC Burn Center located in Los Angeles, California. No other sites, neither regional nor outside of the United States are going to participate in enrollment of subjects.
A General Electric LOGIQ E10 ultrasound machine with a C1-6-XD clear probe, will be used to selectively deliver pulsed ultrasound to the spleen.
12 months.
28 days or until healed (whichever comes first)
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| LOGIQ E10 Sham | Sham Comparator | The sham condition will consist of the ultrasound probe placed over the spleen with no energy applied. |
|
| LOGIQ E10 ultrasound Active | Active Comparator | The intervention condition will receive 10 minutes of splenic ultrasound daily. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pulsed splenic ultrasound | Device | A General Electric LOGIQ E10 ultrasound machine with a C1-6-XD clear probe, will be used to selectively deliver pulsed ultrasound to the spleen. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence and severity of adverse device effects (ADEs) | Review of anticipated device effects after splenic ultrasound insonification in subjects with partial thickness wounds that cover <20% body surface area. | Days 1 -28 |
| Median time to re-epithelialization using advanced digital imaging | Re-epithelialization measured by digital planimetry | 28 days or until healed (whichever comes first) |
| Measure | Description | Time Frame |
|---|---|---|
| Difference in groups in pain measured visual analog scale, (VAS) | Pain, scale 0-10 with 10 being worst outcome | Days 7, 14, 21 and 28 |
| Difference in groups in itch measured visual analog scale, (VAS) |
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Inclusion Criteria:
Exclusion Criteria:
Wounds determined by study clinicians to be ineligible, including those that may inhibit access to the spleen for the ultrasound procedure
Participating in another research study that may affect the conduct of results of this study
BMI > 30
Having or exhibiting any of the following:
Receiving oral, topical, rectal, or parenteral corticosteroids in an unstable dose 4 weeks prior to baseline visit
Any immunosuppressive or cytotoxic medications
Clinically relevant history of alcohol or drug abuse as determined by the investigator including:
Pregnant or breast feeding
Unable or unwilling to comply with study procedures
Have recently (within 3 months) been diagnosed with COVID, or have ever been diagnosed with long COVID
Have an autoimmune disorder, such as, rheumatoid arthritis or lupus
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| Name | Affiliation | Role |
|---|---|---|
| David Armstrong, DPM, MD, PhD | USC Limb Preservation Consortium | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| LAC+USC Medical Center | Los Angeles | California | 90033 | United States |
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| ID | Term |
|---|---|
| D002056 | Burns |
| ID | Term |
|---|---|
| D014947 | Wounds and Injuries |
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| Ultrasound probe (no energy applied) | Device | A General Electric LOGIQ E10 ultrasound probe will be placed over the spleen with no energy applied |
|
Itch, scale 0-10 with 10 being worst outcome
| Days 7, 14, 21 and 28 |
| Difference in groups in non-invasive perfusion measured visual analog scale, (VAS) | Doppler perfusion, scale 0-10 with 10 being worst outcome | Days 7, 14, 21 and 28 |
| Referral to scar management specialist | Scar management | Days 7, 14, 21 and 28 |
| Scar assessments using Patient and Observer Scar Assessment Scale (POSAS) | A 5 point score ranging from 1 (normal pigmentation, no itching) to 5 (worst imaginable scar or sensation). | Days 7, 14, 21 and 28 |
| Multiplexed analysis of plasma levels of inflammatory cytokines | Plasma levels of inflammatory cytokines, lab range values | Days 7, 14, 21 and 28 |
| Flow cytometry analysis of phenotype of macrophage, neutrophil, and T lymphocyte populations | Phenotype of macrophage, neutrophil, and T lymphocyte, lab range values | Days 7, 14, 21 and 28 |