StrataGraft™ Skin Tissue (Human Donor Skin) In The Surgical Management Of Complex Skin Defects

Phase 1

Completed

• Conditions: Wound Infection; Degloving Injury; Third Degree Burn; Burns
• Interventions: Biological: StrataGraft Skin Tissue; Procedure: Cadaver allograft

• Registration Number: NCT00618839
• Lead Sponsor: Stratatech, a Mallinckrodt Company

Brief Summary

This pilot Phase I/II clinical study will be conducted at up to three clinical sites.

This is an open-label, randomized, comparative study with a maximum of fifteen (15) patients, each with skin defects. The patients are intended to undergo sequential surgical procedures involving surgical skin debridement and temporary allogeneic (cadaver skin) grafting at various separate or contiguous wound sites. Patients will be randomized within each wound site to one of two test products: cadaver skin or StrataGraft™ skin tissue.

Detailed Description

Stratatech has completed a phase I/IIa clinical study to assess the safety and efficacy of escalating amounts of StrataGraft skin tissue in patients with complex skin defects requiring sequential debridement and temporary wound coverage with biological dressing prior to autografting. The specific objectives of this phase I/IIa clinical trial were to assess the safety of StrataGraft skin tissue using a predetermined panel of clinical and laboratory endpoints and assess the efficacy of StrataGraft skin tissue by comparing the ability of StrataGraft skin tissue to the standard of care, human cadaver skin, to condition complex skin defects for subsequent autografting. In three cohorts of five patients each, the maximum amount of StrataGraft skin tissue applied to excised full-thickness skin wounds was increased sequentially from 0.5% to 1.0%, and then to 1.5% TBSA. Equivalent study wound areas on each subject were treated with StrataGraft or cadaver allograft for one week, at which time the allograft tissues were removed and the wound bed was evaluated. Infection and appearance of the temporary allogeneic skin tissue were evaluated at every study session until autograft placement. The wound was covered with split-thickness skin autografts when the wound was judged ready to accept an autograft. Autograft take was assessed two weeks after autograft placement.

Study Timeline

• Study Start: 2006-07
• Study First Submitted: 2008-02-07
• Study First Submitted QC: 2008-02-19
• Study First Posted: 2008-02-20
• Primary Completion: 2008-04
• Study Completion: 2008-04
• Results First Submitted: 2009-05-08
• Results First Submitted QC: 2012-08-08
• Results First Posted: 2012-09-10
• Status Verified: 2018-12
• Last Update Submitted: 2019-10-11
• Last Update Posted: 2019-10-16

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 15

Inclusion Criteria

• Patients aged greater than 18 yrs.
• Patients with complex skin defects requiring sequential debridement under anesthesia with temporary biological dressing (allogeneic grafting) prior to autografting
• Full-thickness skin defects
• Informed consent

Exclusion Criteria

• Prisoners
• Pregnant (positive urinary pregnancy in women of child-bearing potential at Visit#1) or lactating females
• Immunosuppressive therapy
• Infection with Human Immunodeficiency Virus
• Venous stasis ulcers of the lower leg
• Diabetic foot ulcers
• Donor site wounds
• Wounds of less than 5% body surface area
• Wounds of the hands, face, and feet (although such wound surface areas can be counted toward total injured BSA)
• Prior entry into this study
• Expected survival of less than 3 months
• Concomitant processes sustained contemporaneously with the dermal injury (e.g., inhalational injury requiring ventilation, electrical injury with cardiac damage or arrhythmia, sepsis, other serious or unstabilized organ damage from trauma, etc.)
• Use of an investigational agent within 30 days
• Active malignancy
• Clinical evidence of malnutrition
• Clinically significant renal, hepatic, cardiac, pulmonary, or neurological impairments

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
StrataGraft : cadaver allograft	StrataGraft Skin Tissue	All patients enrolled received StrataGraft skin tissue and an intrapatient control area treated with cadaver allograft in a split-wound design
StrataGraft : cadaver allograft	Cadaver allograft	All patients enrolled received StrataGraft skin tissue and an intrapatient control area treated with cadaver allograft in a split-wound design

Primary Outcome Measures

Name	Time	Method
Percent Autograft Take on Wounds Prepared by StrataGraft™ Skin Tissue.	two weeks post-autografting	The percentage take of the autografted area on each treatment site based on clinical judgement of visual and tactile assessments two weeks after autografting of wounds that had been temporarily covered with StrataGraft skin tissue.

Secondary Outcome Measures

Name	Time	Method
Appearance of Allograft Tissues	StrataGraft and cadaver allograft appearance were performed every other day after placement and at the time of allograft removal and the values averaged for each subject.	The following three point scale was used to assess the condition of skin allografts: pink and adherent (2 points); either pink or adherent but not both (1 point); or neither pink nor adherent (0 points).
Viability of Allograft Tissues	At the time of allograft removal (~7 days)	Immunohistochemical staining for Ki67, a protein expressed only in proliferating cells.

Trial Locations

Locations (2)

University of Wisconsin-Hospital and Clinics; 🇺🇸 Madison, Wisconsin, United States

Arizona Burn & Trauma Center; 🇺🇸 Phoenix, Arizona, United States