Clinical Trials Logo

Clinical Trial Summary

This is an exploratory randomized controlled trial study to test feasibility, acceptability, and proof of concept efficacy of Continuous Diffusion of Oxygen (CDO) adjunct therapy for decreasing healing time and reducing tissue necrosis post breast reconstruction. The investigator will assess the benefit of this novel adjunct therapy on successful closure, tissue oxygenation, scar appearance, and patients centered outcomes including perception of benefit, pain, sleep quality, and quality of life. Eligible subjects will be randomly (ratio 1:1) assigned to either intervention group (IG) or control group (CG) and will be followed for four weeks. Both groups will receive standard of care for wound treatment. IG will also receive CDO adjunct therapy using a novel dressing, which facilitates continuously supplies oxygen to the wound inside the wound dressing using a portable device named TransCu O2. The study device TransCu O2® is a Class II medical device which has US Food and Drug Administration (FDA) 510(k) clearance, CE-Mark approval and a Health Canada license for the treatment of wounds. Outcomes will be assessed on weekly-basis up to 4 weeks.


Clinical Trial Description

Surgical wound complications such as infection, dehiscence, necrotic tissue, surgical revision, and poor cosmesis are unfortunately highly prevalent in patients post breast reconstruction. In particular, necrosis/ischemia post breast reconstruction because of poor blood circulation is highly prevalent and is estimated to be occurring in up to 75% of cases leading to excessive scar formation. Some factors such as active smoking or an underlying disease such as diabetes and history of radiation therapy could increase the likelihood of excessive scar and/or necrosis. In most cases surgical wounds are managed with a simple island dressing, wool padding and a light retention bandage. It could be argued that such low cost, traditional dressings are adequate for most surgical wounds. However, patients with poor tissue blood circulation often require modern wound care products that offer additional benefits, in particular among those with vascular and poor tissue oxygenation problem. Poor tissue oxygenation and poor skin perfusion could lead to surgical wound complications such as wound inflection, tissue necrosis, pain, trauma and untimely surgical revision. In particular, the presence of non-viable necrotic tissue is significant as it can be responsible for delaying healing, prolonging the inflammatory response, mechanically obstructing contraction and impeding re-epithelialisation. It also provides a focus for wound infection and surgical revision. Even after successful healing, necrotic tissue could still lead to excessive scar formation. Many of these scars can be problematic, being aesthetically unpleasant and causing discomfort. Blood supply is a significant factor in wound healing, and area of the skin with rich supply of vasculature is known to heal with finer scars. Several studies have demonstrated that mild hypoxia (lack of transcutaneous oxygen) is present in early scars, moderate hypoxia in proliferative scars, and severe hypoxia in regressive scars. Oxygen levels then return to normal in mature scars, which is consistent along with the dynamic change in microvessel density. Therefore level of transcutaneous oxygen could be a determinant factor in formation of excessive scar formation. Continuous Diffusion of Oxygen (CDO) is a treatment modality that delivers pure oxygen to wounds using the same basic mechanism as breathing, namely direct diffusion into the wound from a moist surface. Because impaired blood flow results in impaired oxygen supply to incisional wounds, investigators have researched the potential of oxygen saturation, or supersaturation, to reinitiate or even accelerate wound healing. Oxygen has been shown to result in not only faster wound closure, yet also better strength of repair and higher organization of collagen, which in turn can result in lower wound recidivism and better scar appearance. In this feasibility and proof of concept study, The investigator plan to investigate the effects of oxygen on incisional wound repair and scarring after mastectomy and breast reconstruction. The investigator will use a device (TransCu O2® Oxygen Delivery System ) which continuously supplies oxygen to the wound inside the wound dressing. The device the investigator used, the TransCu O2 System, (EO2 Concepts®, San Antonio, TX) is small, wearable and silent. The system is FDA-approved and CDO therapy has been the subject of a growing body of clinical experience and scientific investigations demonstrating good results. The therapy is similar in theory to the intermittent application of oxygen through Hyperbaric Oxygen (HBO) and Topical Oxygen (TO), with a few key differences summarizing in the following: 1) CDO provides continuous therapy, providing ~twenty-fold longer time of oxygen delivery versus intermittent therapies that are only applied 90 minutes a day. 2) CDO allows for full patient mobility during treatment, thereby reducing the risk of non-compliance and reducing overall costs The investigator have successfully used CDO therapy to reduce likelihood of tissue necrosis after surgical closure post lower extremity amputation as well as post parathyroid surgery, in which over 20 subjects were recruited and no adverse outcomes were reported. The investigator plan to extend our study to determine whether CDO therapy would show decreased healing time and better scar cosmesis early on for standardized incisional wounds such as breast reconstruction. The investigator hypothesis that using CDO will reduce the likelihood of necrotic tissue as well as severe incisional scar post-surgical closure by improving transcutaneous oxygen levels during wound healing process. The investigator will examine the validity of this hypothesis using a pilot randomized controlled trial using a convenient sample of 40 people (20 subjects per arm) after mastectomy and breast reconstruction surgery. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT04307355
Study type Interventional
Source Baylor College of Medicine
Contact Bijan Najafi, PhD
Phone 713-798-7536
Email bijan.najafi@bcm.edu
Status Recruiting
Phase Phase 1/Phase 2
Start date June 1, 2021
Completion date December 1, 2024

See also
  Status Clinical Trial Phase
Recruiting NCT04081792 - Optimal Antibiotics for Operated Diabetic Foot Infections N/A
Recruiting NCT02685761 - Skin Incisions and Wound Complication Rates for C-sections in Obese Women N/A
Completed NCT01297322 - RESPECT Trial - (Rapid Extravascular Sealing Via PercutanEous Collagen ImplanT) N/A
Not yet recruiting NCT03872544 - Short Term Status of Free Dermal Fat Autografts for Complex Craniofacial Wounds
Completed NCT03193021 - AMBULATE: Cardiva Mid-Bore VVCS vs. Manual Compression for Multiple Femoral Venous Access Sites, 6 - 12F ID N/A
Not yet recruiting NCT06028854 - Blood Characteristics and Abdominal Emergency Surgery
Completed NCT05646121 - Suprasorb® A + Ag in the Treatment of Wounds at Risk of Infection and Infected Wounds
Enrolling by invitation NCT03880188 - Long Term Status of Free Dermal Fat Autografts for Complex Craniofacial Wounds
Recruiting NCT06342479 - Discharge Training for Patients With Intertrochanteric Fracture N/A
Recruiting NCT03561376 - Zinc Oxide Versus Petrolatum Following Skin Surgery Early Phase 1
Recruiting NCT04994145 - A Post-Market Clinical Investigation on Mepilex Border Post-Op
Recruiting NCT04439552 - fMRI and IVCM Cornea Microscopy of CXL in Keratoconus
Completed NCT05618912 - Scar Appearance After Postoperative Hydrocolloid Dressing Versus Standard Petrolatum Ointment N/A
Completed NCT04596163 - Transversus Thoracis Muscle Plane Block for Sternotomy Pain in Cardiac Surgery N/A
Completed NCT04036344 - Buddy Relationships in DermatoloGic Excisions for Skin Cancer N/A
Completed NCT05791721 - Effect of Preemptive Etoricoxib and Dexamethasone on Wound Healing and Clinical Parameters After Third Molar Surgery Phase 4
Recruiting NCT06073678 - Photobiomodulation in Palate Wounds: Somatosensorial Evaluation N/A
Withdrawn NCT04053946 - Clinical Assessment of Next Science Wound Gels in Healing Below the Knee Amputation Surgical Wound Compared to SOC N/A
Completed NCT05252260 - Comparison of Diode Laser-Assisted Vestibuloplasty And Conventional Vestibuloplasty N/A
Recruiting NCT04740775 - LiquiBand® Exceed™ and LiquiBand® Rapid™ for General Surgery Procedures N/A