Varicose Ulcer Clinical Trial
Official title:
Pragmatic Randomised Controlled Trial of MIST Ultrasound Therapy Compared to UK Standard Care for the Treatment of Non-healing Venous Leg Ulcers.
Chronic venous leg ulcers (VLUs) impact negatively on patients' quality of life. Standard treatment in the UK for patients with VLUs is compression bandaging or stockings. The MIST ultrasound system is a noncontact device which delivers low frequency ultrasound through a gentle saline mist directed at a patient's wound. This study aims to determine whether the use of the MIST device used in combination with standard treatments can improve healing of VLUs compared to UK standard practice. This will be assessed by measuring any reduction in wound size in the two groups after receiving 8 weeks of either Standard Care once a week or MIST combined with Standard Care three times a week.
Venous leg ulcers (VLUs) are wounds which are often chronic and difficult to heal. VLUs
affect between 1 and 3.2 people per 1000; they cause pain, reduced mobility and impact
negatively on patients' quality of life (QoL). Standard treatment for patients with VLUs is
the application of strong, sustained compression with bandages or stockings. This
pragmatically-designed study aims to determine whether the use of a device called MIST used
in combination with standard treatments can improve healing of VLUs compared to UK standard
practice. It will also show whether the MIST regimen improves participants' QoL and reduces
the incidence of infection.
The MIST ultrasound system is a non-contact device which delivers low-frequency ultrasound
through a gentle saline mist directed at a patient's wound. Patients (over 18 years old)
will be invited to take part in this study if they have had a VLU for 6 weeks or more, which
measures between 5 and 100 cm^2, and is not infected. Participants with diabetes must show
good blood glucose control, and those with underlying chronic disorders which may affect
wound healing will be excluded.
All study participants will receive four weeks of standard treatment once a week at a single
clinic at the Wound Healing Research Unit (WHRU), University Hospital of Wales. Patients
whose wounds reduce by more than 40% during this time will be withdrawn from the study.
Remaining patients will be randomly allocated to either the active group or the control
group to receive a further eight weeks of treatment. Participants in the active group will
receive treatment with the MIST device three times a week, as well as standard care (change
of compression bandage and dressings) three times a week. The control group will receive UK
standard care (which is dressing and compression bandage change at least once a week). The
participants' ulcers will be measured and photographed once a week, and the wound
characteristics will be assessed. Changes in participants' health related QoL will be
assessed using a questionnaire at the beginning and end of the trial. Wound recurrence rates
90 days after the end of the treatment will be assessed by telephoning patients.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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