Foot Ulcer, Diabetic Clinical Trial
— DiaFuOfficial title:
Randomized, Controlled Clinical Trial Evaluating the Efficacy and Clinical Effectiveness of Negative Pressure Wound Therapy for the Treatment of Diabetic Foot Wounds When Compared to Standard Wound Therapy
Verified date | April 2020 |
Source | University of Witten/Herdecke |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
On behalf of a consortium of 19 health insurance companies the Institute for Research in
Operative Medicine as part of the University of Witten / Herdecke gGmbH is planning and
conducting a clinical study evaluating the efficacy and effectiveness of negative pressure
wound therapy in the treatment of wound healing disorders of the foot, which are caused by
diabetes mellitus.
This german multicenter study is due to evaluate whether the negative pressure wound therapy
or the control therapy (standard wound therapy following the guidelines) is superior.
Patients will be randomly assigned to the two study arms. Both patients and the treatment
staff know about the specific allocation to the negative pressure wound therapy or standard
wound therapy arm.
A photo documentation and a computer-based evaluation of the wound images will be performed.
This is done centrally by independent examiners, who don`t know neither the patient nor the
treatment assignment.
It is believed that the application of the negative pressure wound therapy systems compared
to standard therapy of diabetic foot wounds will lead more frequent and more rapid to the
achievement of complete wound closure and that the use of negative pressure wound therapy is
an effective and safe therapy option for the treatment of diabetic foot wounds in inpatient
and outpatient care.
Patient´s to be included into the study should have either a chronic diabetic foot wound
existing longer than 4 weeks whereas dead tissue components must be completely removed by the
doctor or a wound after amputation of foot parts.
The study treatment may have already started in the hospital if applicable. The further wound
treatment will be mainly performed within outpatient care. Study Participants will return to
the study centre for regular study visits or even for wound treatment.
The comparison of the outcomes of both study arms will give valuable information about the
efficacy of negative pressure wound therapy in inpatient as well as outpatient care. These
results should be provided until the end of 2016 as a basis for the decision of the Federal
Joint Committee to answer the question if the negative pressure wound therapy can be approved
as a standard service for reimbursement by health insurance companies.
Status | Completed |
Enrollment | 360 |
Est. completion date | April 2015 |
Est. primary completion date | February 2015 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - Presence of diabetes mellitus - Presence of a foot wound (chronic wounds; amputation wounds) Wagner stage 2-4 - Existence of the foot wound for at least 4 weeks - Signed informed consent form - Patient's eligibility of NPWT in the opinion of the treating physician Exclusion Criteria: - Age <18 years - Non-Compliance - Pregnancy - Allergies regarding the release of substances from components of each treatment arm - Severe anemia, wich was not caused by an infection - Simultaneous participation of patients in another interventional study / previous participation in the same study - Use of NPWT systems to the study-related foot lesion within a period of 6 weeks prior to study inclusion - Presence of necrotic tissue with eschar, which can not be removed - Untreated osteitis or osteomyelitis - Not examined / unexplored fistula - Malignancy of the wound - Exposed: nerves, blood vessels, anastomotic site - ambulant NPWT of patients receiving anticoagulants (especially heparinization or marcumar therapy) or with otherwise highly impaired clotting function, which have a risk of circulatory relevant bleeding |
Country | Name | City | State |
---|---|---|---|
Germany | Diabetes Klinik GmbH & Co KG | Bad Mergentheim | |
Germany | Evangelisches Krankenhaus, Königin Elisabeth Herzberge gGmbH | Berlin | |
Germany | Franziskus-Krankenhaus Berlin, Abteilung für Innere Medizin | Berlin | |
Germany | Klinikum Bielefeld, Klinik für Allgemeine und Innere Medizin | Bielefeld | |
Germany | Gerhard Rothenaicher, Facharzt für Chirurgie, München Bogenhausen | Bogenhausen | |
Germany | Knappschaftskrankenhaus Bottrop Klinik für Gefäßchirurgie | Bottrop | |
Germany | Tagesklinik Buchloe | Buchloe | |
Germany | Klinikum Darmstadt, Gefäß- und Endovascularchirurgie | Darmstadt | |
Germany | Klinikum Döbeln | Döbeln | |
Germany | Marienhospital Dortmund-Hombruch, Klinik für Innere Medizin / Diabetologie | Dortmund | |
Germany | Diabetische Schwerpunktpraxis | Duisburg | |
Germany | Malteser Krankenhaus - St. Franziskus-Hospital, Medizinische Klinik I, Abt. f. Diabetologie | Flensburg | |
Germany | Bürgerhospital, Klinik für Diabetologie und Ernährungsmedizin | Frankfurt | |
Germany | Klinikum Frankfurt (Oder), Klinik für Gefäßchirurgie | Frankfurt (Oder) | |
Germany | Goethe Universität Frankfurt am Main, Klinik für Gefäß- und Endovascularchirurgie | Frankfurt am Main | |
Germany | Weißeritztal-Kliniken GmbH Klinik für Gefäßchirurgie-, vaskuläre und endovaskuläre Chirurgie, Phlebologie | Freital | |
Germany | Helfenstein Klinik Geislingen, Allgemein- und Viszeralchirurgie | Geislingen | |
Germany | Asklepios Kliniken Harburg | Hamburg | |
Germany | ASKLEPIOS Westklinikum Hamburg GmbH | Hamburg | |
Germany | Paracelsusklinik am Silbersee, Wundzentrum Hannover | Hannover-Langenhagen | |
Germany | Westküstenklinikum Heide, Klinik für Visceral- und Gefäßchirurgie | Heide | |
Germany | Städtisches Klinikum Karlsruhe GmbH | Karlsruhe | |
Germany | Chirurgische Praxisgemeinschaft am Bayenthalgürtel, Praxis Dr. med. Gerald Engels | Köln | |
Germany | Gemeinschaftspraxis Schlotmann - Hochlenert - Zavaleta - Haberstock | Köln | |
Germany | Krankenhaus Porz am Rhein, Klinik für Gefäßchirurgie | Köln | |
Germany | Alexianer Krankenhaus Krefeld GmbH, Klinik für Allgemein-, Visceral- und Thoraxchirurgie | Krefeld | |
Germany | St. Remigius Krankenhaus Opladen | Leverkusen | |
Germany | Uniklinik Lübeck, Klinik für Allgemeine Chirurgie | Lübeck | |
Germany | Klinikum Ludwigsburg, Klinik für Gefäßchirurgie, vaskuläre und endovaskuläre Chirurgie | Ludwigsburg | |
Germany | Diabetologikum Ludwigshafen, Diabetes-Schwerpunktpraxis | Ludwigshafen | |
Germany | Kliniken Maria Hilf GmbH | Mönchengladbach | |
Germany | Städt. Klinikum Bogenhausen | München | |
Germany | Institut für Diabetesforschung Münster GmbH | Münster | |
Germany | Städtisches Klinikum Neunkirchen gGmbH | Neunkirchen | |
Germany | Gemeinschaftspraxis Drs. Alter, Heim, Pourhassan | Oberhausen | |
Germany | Ortenau Klinikum Offenburg, Klinik für Allgemein-, Viszeral- und Gefäßchirurgie | Offenburg | |
Germany | Klinikum Dorothea Christiane Erxleben Quedlinburg GmbH, Klinik für Allgemein-, Visceral- und Gefäßchirurgie | Quedlinburg | |
Germany | Hegau-Bodensee Klinikum Radolfzell (HBK), Klinik für Innere Medizin | Radolfzell am Bodensee | |
Germany | Thüringen Kliniken "Georgius Agricola", Klinik für Gefäßchirurgie | Saalfeld | |
Germany | St. Marienkrankenhaus Siegen gGmbH, Klinik für Gastroenterologie | Siegen | |
Germany | Mariannen-Hospital Werl, Abteilung für Chirurgie | Werl | |
Germany | HSK - Dr. Horst Schmidt Kliniken GmbH | Wiesbaden |
Lead Sponsor | Collaborator |
---|---|
University of Witten/Herdecke | Kinetic Concepts, Inc., Smith & Nephew Wound Management Inc |
Germany,
Seidel D, Mathes T, Lefering R, Storck M, Lawall H, Neugebauer EA. Negative pressure wound therapy versus standard wound care in chronic diabetic foot wounds: study protocol for a randomized controlled trial. Trials. 2014 Aug 27;15:334. doi: 10.1186/1745-6215-15-334. — View Citation
Seidel D, Storck M, Lawall H, Wozniak G, Mauckner P, Hochlenert D, Wetzel-Roth W, Sondern K, Hahn M, Rothenaicher G, Krönert T, Zink K, Neugebauer E. Negative pressure wound therapy compared with standard moist wound care on diabetic foot ulcers in real-l — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Number of achieved and confirmed wound closures within the maximum study treatment time | Complete wound closure is defined as 100% epithelialization; no need for drainage, no need for supportive therapy or a means of assistance and absence of suture material. Wound closure must sustain at least for a period of 14 days and needs to be confirmed within a separate study visit 14 days after the first diagnosis of wound closure. | 16 weeks | |
Primary | Time until wound closure within the maximum study treatment time | Complete wound closure is defined as 100% epithelialization; no need for drainage, no need for supportive therapy or a means of assistance and absence of suture material. Wound closure must sustain at least for a period of 14 days and needs to be confirmed within a separate study visit 14 days after the first diagnosis of wound closure. | 16 weeks | |
Secondary | Time until optimal wound bed preparation | Time until optimal preparation of the wound bed for further therapy (granulation of at least 95%) | 16 weeks | |
Secondary | Time until wound closure within the observation period | Time to reach a complete wound closure within the observation period of 6 months | 6 months | |
Secondary | Recurrences | Recurrences within the observation period of 6 months after complete and confirmed wound closure | 6 months | |
Secondary | Amputations | Appearance and dimension of amputations | 16 weeks | |
Secondary | Wound size | Wound size over time | 16 weeks | |
Secondary | Wound tissue qualities | Proportion of wound tissue qualities over time | 16 weeks | |
Secondary | Number of complete wound closures within the observation period | Number of complete wound closures achieved within the observation period of 6 months | 6 months | |
Secondary | Wound-related pain (Numeric Rating Scale) | Patient`s pain measured with a numeric Rating scale at each study visit | 16 weeks | |
Secondary | Quality of Life questionaire (EQ-5D) | EQ-5D at inclusion, end of maximum treatment time or end of therapy, Follow-Up after 6 months | 6 months | |
Secondary | Direct costs | direct medical resource use and costs: hospitalization, outpatient contact with study centre and other providers, reimbursable drugs, medical sundries, adjuvants, reimbursable services direct non-medical resource use and costs: services, travel costs, expenditure of time for patients, expenditure of time for lay care | within a maximum treatment time of 16 weeks or until end of therapy | |
Secondary | Indirect costs | disability, disability pension, premature death | within a maximum treatment time of 16 weeks or until end of therapy | |
Secondary | Serious adverse events | All adverse events that result in death, are life-threatening, require inpatient hospitalization or causes prolongation of existing hospitalization, result in persistent or significant disability/incapacity, are a congenital anomaly/birth defect, or require intervention to prevent permanent impairment or damage. | 6 months | |
Secondary | Adverse Events | wound specific and device specific adverse events within the maximum study treatment time | 16 weeks |
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