Venous Ulcer Clinical Trial
Official title:
A Prospective, Randomized, Controlled Clinical Study to Evaluate the Effectiveness of a Cellulose Matrix Wound Dressing for Autolytic Debridement and Healing of Chronic Venous Ulcers
This clinical trial is designed to evaluate the effect of XCell cellulose wound dressing for its ability to naturally (autolytically) remove nonviable tissue and create a healthy vascular wound bed. Results will compare venous ulcers treated with Xylos XCell cellulose dressing plus standard care to those treated with standard care alone. The hypothesis is that XCell will demonstrate more autolytic debridement than the standard of care.
Chronic wounds are a problem for both the patient and the health care provider. The
definition of a chronic wound is one that deviates from the expected sequence of repair in
time, appearance and response to aggressive treatment. These wounds can be separated into
distinct classes by etiology, specifically, pressure, ischemic, venous, neuropathic,
diabetic, inflammatory or infective wounds. The degree of severity can be quite diverse
spanning the range of superficial epidermal injury to full-thickness skin loss with
extensive destruction, tissue necrosis, and damage to supporting structures including
muscle, tendon, and or bone. Treatment of chronic wounds should begin with the management of
the underlying etiology. For example: In pressure ulcers the elimination or reduction of
pressure is the primary goal; In venous ulcers, improving venous insufficiency or reducing
venous hypertension should come first; and in diabetic foot ulceration, proper off loading
is essential. After treatment of the underlying pathology, one thing that all chronic wounds
have in common is that they require wound bed preparation in order to stimulate the healing
process.
Most clinical wound care trials to evaluate therapeutic agents for wounds have been designed
to measure healing as the primary endpoint. The sequence of events begins with patient
examination, wound classification and then the application of the test agent. In most cases,
the test agent is placed over a wound that is contaminated with excessive bacteria, needs
debridement, or requires wound bed preparation such as exudate control.
A new wound dressing (Xylos XCell cellulose wound dressing) is a unique biosynthetic matrix
material that is hydrophilic and has excellent tensile strength. It has the ability to
deliver moisture into a wound or absorb moisture. This cellulose matrix is microbially
derived, biocompatible, pyrogen-free and completely non-toxic. In previous clinical trials
this dressing displayed the ability to aid the natural process of autolytic wound
debridement, cleansing and exudate control. From initial observations, it appears that this
cellulose matrix provides an environment that prepares the wound bed by eliminating
nonviable tissue, reducing bacterial burden, controlling exudate and exposing healthy
granulation tissue. With successful wound bed preparation one can now concentrate on healing
the chronic wound.
This clinical trial is designed to evaluate the natural cleansing (autolytic debridement
process) and healing attributes of this new cellulose wound dressing compared to standard of
care (impregnated gauze). Venous ulcers have been chosen as the model because these wounds
are often covered with thick fibrous non-viable tissue, are poorly vascularized, are
contaminated with numerous bacteria and exude copious amount of wound fluid.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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