Wound Infection Clinical Trial
Official title:
A Randomized, Site-Matched, Controlled Trial of exSALT SD7™ Compared to Xeroform® Petrolatum Dressing for the Management of Partial Thickness Donor Sites
This randomized, controlled trial is designed to evaluate split-thickness donor sites treated
with exSALT SD7™ compared to donor sites treated with Xeroform®. For the purpose of this
study, subjects enrolled will have selected donor sites or portions of donor sites designated
as "Test Sites." The selected locations will be randomly assigned treatment with either the
Test Dressing or the Control Dressing.
The primary objective of the trial will be to quantify the proportion of the donor sites in
each group that are healed at 10 and 14 days. Secondary objectives will include: time to
re-epithelialization, pain with dressing changes and mobilization, ease of use, resource
utilization and safety, as well as quality of healing and overall cosmetic result. A total of
25 subjects will be enrolled in the trial.
The trial duration will be 12 weeks. For the purposes of this trial, healing will be defined
as ≥ 90% re-epithelialization and must be visually confirmed by the investigator or designate
and two other people (i.e., research nurse, burn resident, member of the Wound Care Team).
The maximum time to evaluate healing will be 14 days +/-2 days. A final visit will be
conducted at 12 weeks for safety and to evaluate the quality of healing.
Autologous skin grafting is a common procedure required in the care of burn and plastic
surgery patients where the harvesting of autologous skin grafts results in the creation of a
partial thickness wound known as a donor site. The donor site healing time can affect the
length of hospitalization and subject survival.
The literature reports the use of a variety of donor site dressing materials including fine
mesh gauze, polyurethane film, synthetic fiber and hydrocolloids (Kilinc, Sensoz et al.
2001). The literature reports what might be considered the optimal donor site dressing
attributes. These attributes would include: minimizing pain, velocity in healing, minimizing
bacterial growth and simplicity in use (Rakel, Bermel et al. 1998).
However, none of the available dressing products are entirely satisfactory. Fine mesh gauze
(FMG) is the donor site dressing used at many burn centers, as it is inexpensive, can be
placed on posterior donor sites, does not require a margin of intact skin and allows large
amounts of exudate to drain away from the donor site.
However, FMG does not have any inherent anti-infective properties and provides a dry
environment for wound healing. Xeroform® Petrolatum Dressing resembles FMG physically except
that it contains 3% xeroform (bismuth tribromophenate) which exerts some antibacterial effect
(Feldman, Rogers et al. 1991). Xeroform® Petrolatum Dressing is the standard donor site
dressing in the Firefighters' Burn Treatment Unit (3C2 WMC) and Plastic Surgery Unit (3D3
WMC) and has been selected as the control treatment (Control Dressing).
Research evidence demonstrates that partial thickness wounds re-epithelialize more rapidly in
a moist environment that is free from infection (Alper 1986; Alvarez 1988). In an effort to
provide an improved method of dressing wounds and donor sites, exSALT SD7™ has been proposed
as an alternative dressing (Test Dressing). The dressing is intended to reduce pain and
discomfort and improve the re-epithelialization process by providing a moist environment. The
model outlined in this protocol provides the basis for a controlled comparison of wound
healing and re-epithelialization in a clean partial thickness wound that allows us to compare
the healing rate and quality of the Test Dressing compared to our standard of care to
determine safety and efficacy.
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