Venous Ulcer Clinical Trial
Official title:
A Randomised Controlled Clinical Trial Comparing the Effectiveness of Bandaging Compared to the Juxta-CuresTM Device in the Management of People With Venous Ulceration: Feasibility Study
Venous ulceration is a major burden on the NHS. Current treatment involves bandaging therapy which is replaced on a once or twice weekly basis. The Juxta-CuresTM device offers an alternative solution for the long-term treatment of patients with venous ulceration. This is a removable adjustable device with an inbuilt pressure monitor. The aim of this study is to determine whether the Juxta-Cures™ device provides at least equivalent ulcer healing for patients with venous ulceration compared to bandaging. Secondary outcome measures include whether the Juxta-Cures™ device improves patient compliance and quality of life compared to bandaging, and whether the Juxta-Cures™ device is cost effective compared to bandaging.
Participants with lower leg ulceration will be identified at consultant or nurse-led clinics.
They will be assessed by their clinician, and identified as having a likely venous ulcer.
Participants undergoing current leg ulcer management of any type may be considered for this
trial. At this stage participants will be given the most recent version of the patient
information sheet, given appropriate initial treatment as determined by their clinician
(simple dressings, or compression bandaging if appropriate), and booked for venous and
arterial duplex as well as ABPI which will be undertaken within 10 +/- 4 days. The patient
will then be reviewed in 10 days +/- 4 days at venous ulcer clinic to discuss any queries
regarding the trial with their clinician. Informed consent will be obtained from all
participants at this point if appropriate, and the patient will be randomised, (a minimum of
24 hours will be required for the patient to read the information prior to giving informed
consent).
Following randomisation the participant will be reviewed in the leg ulcer clinic on a 10 +/-
4 days basis whereby pressure monitoring will be conducted using the PicoPress® (Microlan
Italia, Padua, Italy), dressings will be changed and ulcer measured with standard 1cm squared
grids, and the Silhoutte® 3D wound imaging system (ARANZ Medical Ltd, Christchurch, New
Zealand). Participants will also submit their daily use and pressure diary. The type of
dressings applied will also be recorded as well as length of appointment.
50 participants will be recruited (aim for study duration of 12-18 months) from a consultant
or nurse-led clinic at Colchester Hospital and associated outlying clinics, and participants
randomised to receive either compression bandages or Juxta-Cures™ (bilateral participants
will be allocated a single treatment, rather than randomisation of individual limbs).
Patients with 'wet' ulcers may receive absorbent dressings under Juxta-Cures™ or compression
bandaging during the study period, which will be recorded on the weekly data collection for
cost analysis purposes.
At baseline, 1 month, 3 months and 6 months all participants will complete health related
quality of life questionnaires. The disease specific VEINESqol/sym, and generic Euroqol-5D-5L
surveys will be used, and received positive feedback regarding their content at the patient
focus group.
The planned study period for the randomised-control trial is 24 weeks for each participant,
but 1 year in total for patient recruitment and analysis.
This study is a feasibility study therefore has not been powered. Following this study the
investigators aim to undertake a multi-centre study in collaboration with the Vascular and
Endovascular Research Network (VERN), powered to venous ulcer healing at 90% power, using the
results of this feasibility study.
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