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Lack of funding to support the study
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Chronic leg ulcerations are a great burden for patients and the medical system alike. Frequent outpatient consultations with associated treatment costs and travel costs for the patient as well as psychosocial burdens remain an unmet problem in chronic wound care. There is an increasing need for definitive treatment of especially chronic venous and multifactorial chronic leg ulceration where arterial intervention is not a treatment option.
Minimal invasive surgical interventions that do not require skin grafting can be performed under local anesthesia in an outpatient setting even in multimorbid patients.
Kerecis Omega3 Wound is intact decellularized fish skin. The fish skin sheets contain fat, protein, elastin, glycans and other natural skin elements and it can be an effective treatment option in chronic leg ulcerations and is licensed for this use as a medical product in Switzerland. However, limited data without inter-wound bias is available for the use of Kerecis Omega 3 in chronic leg ulcerations.
In this study the investigators propose to investigate the efficacy of Kerecis Omega 3 according to objective wound surface measurements using standardized digital photographs in patients with chronic leg ulcerations. Efficacy will be evaluated against standard of care wound debridement.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Kerecis Omega 3 | Experimental |
| |
| Surgical debridement | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Kerecis Omega 3 | Device | Decellularized intact fish skin developed for the management of chronic wounds |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in ulcer surface area | Change in ulcer surface area as assessed by standardized photography and digital imaging. | 12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Change in patient quality of life | Change in patient quality of life as assessed by the Wound-QoL questionnaire score, ranging from 0 to 4, with higher scores indicating a worse quality of life. | 2, 4, 6 and 12 weeks |
| Change in wound microbiota as assessed by alpha diversity of the microbial composition |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of adverse events | Cumulative incidence of treatment-related adverse events | 12 weeks |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Simon Bossart, MD | Department of dermatology, University Hospital Inselspital, Bern | Principal Investigator |
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| ID | Term |
|---|---|
| D007871 | Leg Ulcer |
| ID | Term |
|---|---|
| D012883 | Skin Ulcer |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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1:1 in-wound split design with random allocation
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| Surgical debridement | Procedure | Superficial sharp surgical debridement technique |
|
Change in wound microbiota utilizing 16S-sequencing from wound swabs as assessed by alpha diversity of the microbial composition trough Shannon index, with higher scores indicating a more diversity of the species |
| 2, 4, 6 and 12 weeks |
| Change in wound microbiota as assessed by beta diversity of the microbial composition | Change in wound microbiota utilizing 16S-sequencing from wound swabs as assessed by beta diversity of the microbial composition trough Shannon index, with higher scores indicating a more diversity of the species. | 2, 4, 6 and 12 weeks |
| Change in ulcer surface area | Change in ulcer surface area as assessed by standardized photography and digital imaging. | 2, 4, 6 and 12 weeks |