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Violet-Blue Light Inactivation of Bacteria in Chronic Wounds

Not Applicable
Completed
Conditions
Phototherapy Complication
Wound Infection
Wound Heal
Light Treatment; Complications
Photobiology
Interventions
Device: Violet-Blue Light Treatment / FlashHeal Device
Registration Number
NCT05739058
Lead Sponsor
Bispebjerg Hospital
Brief Summary

This four-week prospective clinical investigation will assess the safety and feasibility of a medical device without CE-marking. The medical device is a light-emitting-diode (LED) and is manufactured by VulCur MedTech Aps. Violet-blue light treatment is tested on a total of twenty-two patients with chronic wounds, divided into three groups, each group only receiving one dosage. Three dosages (low, medium and high) of violet-blue light treatment is tested. ID 1-7 are assigned to the low group, ID 8-15 are assigned to medium group and ID 16-22 are assigned to the high dosage group.

Detailed Description

This is as prospective safety and feasibility clinical trial investigating violet-blue light treatment on chronic wounds. This clinical trial runs from Q3 2022 - Q2 2023. Twenty-two patients with chronic wounds will be included (n = 22) for a study-period of four weeks. Week 1 includes one baseline visit. Through Week 2,3 and 4 treatment is given six times with a span of 24-72 hours between every treatment visit. Week 4 includes one follow up-visit. Patients entering the study are assigned to three light dosage groups (low, medium and high) according to their study ID. ID 1-7 are assigned to the low group, ID 8-15 are assigned to medium group and ID 16-22 are assigned to the high dosage group. Between each dosage of light, there will be an evaluation of primary and secondary endpoints by the sponsor and the principal investigator. Light dosage is only escalated should this evaluation be deemed safe. To determine treatment safety skin reactions are assessed after treatment at: 0 minutes, 30 minutes, 24 hours, 48 hours, 5th treatment visit and at follow-up. Adverse Events and Adverse Device Events are evaluated at every visit for every dosage, feasibility is evaluated at follow-up for both patient and investigator. This investigation complies with the Good Clinical Practice concerning medical devices and follows the ISO standard DS/EN 14 155 and the Declaration of Helsinki

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
22
Inclusion Criteria
  • Men, women and non-binaries fulfilling all inclusion criteria
  • Age >18 - Patients with a chronic wound defined > 6 weeks
  • Wound Area > 1 cm and < 25 cm
  • Patient can understand Danish
  • Patient can comply with protocol
  • Patient is fully informed about the study and has given informed consent
Exclusion Criteria
  • Clinical infection in the wound requiring systemic or local antibiotics
  • Current intake of antibiotics or locally applied (within 7 days before baseline)
  • Known or suspected cancer in the wound
  • Previous Photodermatitis and/or Photosensitivity
  • Previous Porphyria and/or hypersensitivity to porphyrins
  • Known congenital or acquired immunodeficiency
  • Newly adjusted or newly started systemic immunomodulate treatment >4 weeks
  • Treatment with haemodialysis
  • Dementia - Participating in other clinical wound healing studies in the last 30 days
  • Judgement by the investigator that the patient is not suited for study participation
  • Pregnant or breastfeeding women. (All fertile women who is not on safe contraception will need a negative pregnancy test performed at baseline. Safe contraception includes cobber and hormone Intra Uterine Device and Hormone anticonception drugs. Sterility is defined as have had surgical sterilisation and being postmenopausal)

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Low Exposure to Violet-Blue LightViolet-Blue Light Treatment / FlashHeal DeviceID 1-7 are assigned to the low dosage group
Medium Exposure to Violet-Blue LightViolet-Blue Light Treatment / FlashHeal DeviceID 8-15 are assigned to the medium dosage group
High Exposure to Violet-Blue LightViolet-Blue Light Treatment / FlashHeal DeviceID 16-22 are assigned to the high dosage group
Primary Outcome Measures
NameTimeMethod
Overall Common Terminology Criteria for Adverse Events, version 5.0, Nov 27, 2017 (CTCAE)4 weeks

Safety is measured as the absence of Adverse Events (AE) skin reactions. Adverse event skin reactions are assessed with the Common Terminology Criteria for Adverse Events U.S Department of Health and Human Services version 5.0, Nov 27, 2017 (CTCAE) adjusted to the skin. The violet-blue light treatment will be considered safe when less than 30 % have an overall CTCAE score larger than Grade 2 CTCAE. The overall CTCAE score for each patient is based on the one CTCAE score with the most severe grading.

Secondary Outcome Measures
NameTimeMethod
Baseline Clinical Wound AssessmentBaseline, 1 week

Evaluates wound symptoms (Exudate, necrosis, maceration, granulation, Oedema,) and skin symptoms (eczema, Erythema, Hyperpigmentation, Hypopogmentation, epthilializing) at a 4 step scale from none to mild, moderate, severe.

Investigator Questionnaire4 weeks

Usability of the medical device is tested with the system usability Scale (SUS) testing 10 items on a 5 step scale from Strongly Disagree to Strongly Agree.

Mean time of visitFor every visit, up to 4 weeks

Total time for the visit will be measured in minutes.

Change from Baseline Wound Fluid Composition Week 1 to Week 22 Weeks

Swab for wound fluid performed once every week using the Essen Rotary Technique, testing for 6-10 cytokines assessing the inflammatory microenvironment.

Pre-intervention Mean Bacterial LoadPre-intervention, up to 3 weeks

E-Swabs, Essen Rotary Technique performed at baseline, follow-up and before and after treatment with FlashHeal Device. Bacteria will be cultured for aerobe and anaerobe species.

Clinical Wound AssessmentPre-intervention, up to 3 weeks

Evaluates wound symptoms (Exudate, necrosis, maceration, granulation, Oedema,) and skin symptoms (eczema, Erythema, Hyperpigmentation, Hypopogmentation, epthilializing) at a 4 step scale from none to mild, moderate, severe.

Follow up Clinical Wound AssessmentFollow Up, up to 4 weeks

Evaluates wound symptoms (Exudate, necrosis, maceration, granulation, Oedema,) and skin symptoms (eczema, Erythema, Hyperpigmentation, Hypopogmentation, epthilializing) at a 4 step scale from none to mild, moderate, severe.

Baseline Wound FluidBaseline, 1 Week

Swab for wound fluid performed once every week using the Essen Rotary Technique, testing for 6-10 cytokines assessing the inflammatory microenvironment.

Patient Questionnaire4 weeks

Evaluating Participant perceived; pain, time consumption and satisfaction through 20 items.

Question 1-13 can be answered on a 5 step scale from "to a very high degree" till "not at all", including possibility to answer "dont know" and "not relevant".

Item 14-20 can be answered with "Yes", "No" and "Dont Know".

Mean time of Treatment ProcedurePost-intervention, up to 3 weeks

For every treatment visit, time used for the treatment with the FlashHeal Device is measured.

Time is measured in minutes.

Common Terminology Criteria for Adverse Events, version 5.0, Nov 27, 2017 (CTCAE)Follow Up, 4 weeks

Safety is measured as the absence of Adverse Events (AE) skin reactions. Adverse event skin reactions are assessed with the Common Terminology Criteria for Adverse Events U.S Department of Health and Human Services version 5.0, Nov 27, 2017 (CTCAE).

The CTCAE is adjusted to the skin.

Numeric Rating Scale (1-10)Post-intervention, up to 3 weeks

Pain scale in relation to treatment. Higher scores indicate more pain.

Wong Baker FACES (1-10)Post-intervention, up to 3 weeks

Visual Pain scale in relation to treatment. Higher scores indicate more pain.

Baseline Mean Bacterial Load1 week

E-Swabs, Essen Rotary Technique performed at baseline, follow-up and before and after treatment with FlashHeal Device. Bacteria will be cultured for aerobe and anaerobe species.

Post-intervention Mean Bacterial LoadPost-intervention, up to 3 weeks

E-Swabs, Essen Rotary Technique performed at baseline, follow-up and before and after treatment with FlashHeal Device. Bacteria will be cultured for aerobe and anaerobe species.

Mean Bacterial Load at Follow UpFollow up, up to 4 weeks

E-Swabs, Essen Rotary Technique performed at baseline, follow-up and before and after treatment with FlashHeal Device. Bacteria will be cultured for aerobe and anaerobe species.

Change from Baseline Wound Fluid Composition Week 1 to Week 33 Weeks

Swab for wound fluid performed once every week using the Essen Rotary Technique, testing for 6-10 cytokines assessing the inflammatory microenvironment.

Change from Baseline Wound Fluid Composition Week 1 to Week 44 weeks

Swab for wound fluid performed once every week using the Essen Rotary Technique, testing for 6-10 cytokines assessing the inflammatory microenvironment.

Baseline Wound Size Week 1Baseline, week 1

Clinical Photography is performed once every week. Hereafter the wound is analysed with the ImageJ software to calculate wound size in cm2.

Change from Baseline Wound Size Week 1 to Week 4Follow Up, 4 weeks

Clinical Photography is performed once every week. Hereafter the wound is analysed with the ImageJ software to calculate wound size in cm2.

Change from Baseline Wound Size Week 1 to Week 22 Weeks

Clinical Photography is performed once every week. Hereafter the wound is analysed with the ImageJ software to calculate wound size in cm2.

Change from Baseline Wound Size Week 1 to Week 33 Weeks

Clinical Photography is performed once every week. Hereafter the wound is analysed with the ImageJ software to calculate wound size in cm2.

Trial Locations

Locations (1)

Danish Wound Healing Center, Bispebjerg Hospital

🇩🇰

Copenhagen, Northwest, Denmark

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