Preoperative Jumpstart for Decolonization of P. Acnes

Not Applicable

Terminated

Conditions: Shoulder Arthropathy Associated With Other Conditions

Interventions: Device: JumpStart Antimicrobial Wound Dressing

Registration Number: NCT03466658

Lead Sponsor: Milton S. Hershey Medical Center

Brief Summary: The objective of the study is to evaluate the efficacy of preoperative treatment with a novel, wireless, low-level microcurrent-generating antimicrobial device (brand name: JumpStart) in preventing the spread of Propionibacterium acnes in patients receiving open or arthroscopic shoulder surgery.

Detailed Description: The spread of multi-drug resistant bacteria and financial burden of periprosthetic joint infection exacerbate the need for treatments to address pathogenic contamination and expedite healing. Although rare, these infections can place a great financial burden on the health care system and are often associated with increased hospital length of stay, compromised function, reduced quality of living, and increased likelihood of follow-up surgeries. Bacterial infection can further compound this problem with the widespread, prolonged use of prolonged antimicrobial prophylaxis. It is know that there is a high frequency of infections after open and arthroscopic shoulder surgery caused by Propionibacterium acnes. Because P. acnes normally colonizes under the epidermal layer in sebaceous glands, topical skin preparations, skin cleansers, and antibiotics may be unable to completely penetrate the deep layers of the skin to eradicate its colonization in all layers of the skin.

A novel, wireless, low-level microcurrent-generating antimicrobial device has been observed, in vitro, to exhibit electricidal effect in the presence of antibiotic and multidrug resistant clinical wound isolates. These energy-based systems were originally employed to augment wound healing process, reduce infection, and address edema and pain in the recent decades. Low-level microcurrents have been recently expanded into the orthopedic space as a bacterial growth inhibitor both in vitro and in vivo. Procellera (JumpStart) is a sterile single layer dressing consisting of a matrix of alternating silver (Ag) and zinc (Zn) dots that are held in positions on a polyester substrate with biocompatible binder. Dressing is then activated in the presence of a conductive fluid, which may come from wound exudate or exogenous fluids, such as saline.

Many studies have been done already on the wound healing and pain management properties of JumpStart, but only few have explored its bactericidal properties. To date, no MRSA strains have been found to possess Ag-resistant genes, and there is no known mechanism of bacterial resistance to all heavy metal ions. However, studies have suggested that the widespread and uncontrolled use of Ag+ in wound care may result in more bacteria developing resistance.

Recruitment & Eligibility

Status: TERMINATED

Sex: All

Target Recruitment: 17

Inclusion Criteria

18 years old or older
Scheduled to receive open or arthroscopic shoulder surgery

Exclusion Criteria

17 years old or younger
Pregnant women
Prisoners
Non-English speaking or unable to understand consent
History of any prior shoulder surgery
History of previous shoulder infection or clinical signs of preoperative infection
History of taking any antibiotic(s) within 4 weeks prior to the scheduled shoulder surgery
Active acne or skin inflammatory disorders (psoriasis, eczema, etc) in the shoulder

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
JumpStart group	JumpStart Antimicrobial Wound Dressing	This group will have the JumpStart dressing pre-operatively. Intervention: JumpStart dressing

Primary Outcome Measures

Name	Time	Method
Presence of Propionibacterium Acnes in Skin Biopsies During Surgery	7 days post-biopsy	The primary outcome measures the intraoperative culture results (e.g. positive vs negative, days to positive conversion) for P. acnes by evaluating bacterial cultures from punch skin biopsies at the time of the surgery.

Secondary Outcome Measures