Wounds and Injuries Clinical Trial
Official title:
Odor Management in Fungating Wounds Comparing Metronidazole and Polihexanide: Randomized Clinical Trial
For odor control malignant wounds (MW), use is 0.8% metronidazole solution - second
recommendation scientific and clinical practice. But no this formulation available in Brazil
, and its application to nursing steeps metronidazole tablets , diluted in saline and applied
to the bed of (MW) . Thus , it is used off label for metronidazole ( tablets orally applied
via " topical " - but it is not intact skin or mucosa ) , nursing and eventually manipulate
the solution at bedside , and by law this power is pharmacist bedside and can not be taken .
Family antiseptic chlorhexidine was developed with the purpose of use in infected wounds
called polihexanide ( PHMB ) . In Brazil is now available for hospital and home care ( 0.2 %
Aquasept ® ) use. Evidence reported positive results in controlling infection of chronic
wounds such as pressure ulcers . Although not tested its efficacy in odor control. Thus the
study aims to compare metronidazole solution 0.8 % versus 0.2 % PHMB in odor control , where
, if the results are favorable to PHMB we have a treatment option in odor control with ready
to use formulation and easy access . Evaluate and compare the effectiveness of metronidazole
solution 0.8% and polihexanide solution (PHMB) in odor control in MW. Aims: Evaluate and
compare the time needed for odor control (reduction in days), using metronidazole and PHMB in
MW (primary endpoint); Evaluate and compare the perceptions of patients, nurses and
researcher on the odor MW, using metronidazole and PHMB in the MW; Evaluate and compare the
pain reported by patients during dressing changes, using metronidazole and PHMB in the MW;
Evaluate and compare the quality of life of patients before and after the use of
metronidazole and PHMB in MW. This is a randomized, double -blind study with patients
diagnosed with cancer and patients with MW with odor clinical trial . The sample consisted of
24 subjects divided into 2 groups (control - metronidazole group and experimental group -
PHMB ) , recruited in one cancer hospital in the city of São Paulo (AC Camargo Cancer
Center), which has as protocol description in odor control MW metronidazole . After
acceptance by the subject and return the Statement of Informed Consent signed , randomization
will be done .
For blinding , 0.8 % metronidazole solution will be provided by a compounding pharmacy (after
stability testing of tablet diluted - and then stipulated expiration date) , and PHMB be
bought from the supplier , delivered to the same compounding pharmacy which stores the PHMB
in identical bottles to metronidazole ( only the responsible researcher will know to which
group the subject was randomized ) .
The evaluation of the odor will be taken by 3 " employees " and the patient through 3 scales
at zero , four, eight and twelve days ( or earlier if classified as " odorless " by 3
reviewers and the patient ) . Two scales about painful sensations in exchange for healing ,
one on quality of life will be applied to the patient and a specifically on the impact of
odor on the subject's life.
To meet the proposed objectives, the data will be analyzed by: Friedman test to assess the
odor reduction with respect to time; Mann-Whitney (or t test) for comparison of groups and
the Fisher exact test to compare proportions. Data will be presented in the form of frequency
tables for categorical variables and means, standard deviations and position measurements for
quantitative variables. Will also be performed non-parametric analysis of ordinal data, or
parametric analysis with Generalized Estimation Equation for binomial variables, depending on
the data distribution and the sample size.
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