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A Phase I, Single-blind, Randomized Study of the Safety and Efficacy of Cellularized Integra® Using Autologous Burn-derived Stem Cells

Phase 1
Not yet recruiting
Conditions
Burns
Interventions
Device: Integra®
Device: Integra®-SC
Registration Number
NCT05344521
Lead Sponsor
Hamilton Health Sciences Corporation
Brief Summary

Burn injuries are one of the most severe skin injuries and lead to a complex wound healing response. When the skin is wounded, stem cells in the skin must respond fast to help repair the injured tissue. The damaged skin of burn patients contains cells that are still alive and have typical stem cell characteristics. Because stem cells are so important for wound healing, the investigators have combined them with an existing skin substitute, Integra®, to examine the potential wound healing benefits of these stem cells. This is an investigational treatment and a first in-human trial. The purpose of this study is to test the safety of using a patient's own stem cells combined with Integra®, which the investigators call Integra®-Stem Cells (Integra®-SC). The investigators hypothesize that Integra®-SC will result in improved wound healing, better scar quality, and decreased scar formation at one-year post-injury.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
29
Inclusion Criteria
  • Aged ≥ 18 years.
  • Total body surface area (TBSA) ≥ 5%.
  • Full-thickness burn requiring operative procedures.
  • Admitted ≤ 120 hours following burn.
  • Injury location includes a contralateral area.
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Exclusion Criteria

All participants meeting any of the following exclusion criteria at baseline will be excluded from participation in this study:

  • Patients who are moribund.
  • Known infection with any of the following: Human Immunodeficiency Virus (HIV), Hepatitis B, Hepatitis C, Human T-lymphotropic Virus (HTLV), Syphilis, or West Nile Virus.
  • Injury location limited to face and/or hands.
  • Pregnancy.
  • Active cancer and currently undergoing treatment.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ControlIntegra®After removal of the temporary wound coverage (allograft), Integra® is applied directly onto the wound surface.
Integra®-SCIntegra®-SCAfter removal of the temporary wound coverage (allograft), Integra®-SC is applied to the contralateral area of the site where Integra® is applied.
Primary Outcome Measures
NameTimeMethod
Safety - Number of participants with non-healing woundsAcute hospitalization (1-4 months post admission depending on severity of injury)

The primary outcome of this study is safety. In order to assess the safety of Integra®-SC, non-healing wounds that require an additional (unplanned) operation will be recorded as an in-hospital complication.

Safety - Number of patients with poor scarring requiring additional (unplanned) operationDischarge to to 1 year post-discharge

The primary outcome of this study is safety. In order to assess the safety of Integra®-SC, poor scarring requiring an additional (unplanned) operation will be recorded as a late-onset complication.

Safety - Number of participants with surgical site infectionsAcute hospitalization (1-4 months post admission depending on severity of injury)

The primary outcome of this study is safety. In order to assess the safety of Integra®-SC, surgical site infections that require an additional (unplanned) operation will be recorded as an in-hospital complication.

Secondary Outcome Measures
NameTimeMethod
Scar Formation - Vascularity of the healed areaDischarge to 1 year post-discharge

Vascularity of the healed area is assessed as part of the Vancouver Scar Scale to evaluate scar formation over time. Vascularity is scored from 0 to 3, with higher scores indicating worse outcomes. Photography and evaluation of treated area for scar formation will be assessed at outpatient follow-ups at approximately 30 days, 60 days, 90 days, 180 days, and 365 days post-discharge (with 2-4 weeks deviation). Follow-ups typically take place in-person at clinic visits, but may take place online via a secure platform.

Quality of skin regeneration - Signs of wound infectionAcute hospitalization (1-4 months post admission depending on severity of injury)

Classic signs of wound infection will be recorded to assess the quality of skin regeneration. Photography and evaluation of wounds will occur at enrollment, operation days, dressing take-downs, and discharge from hospital.

Scar formation - Pliability of the healed areaDischarge to 1 year post-discharge

Pliability of the healed area is assessed as part of the Vancouver Scar Scale to evaluate scar formation over time. Pliability is scored from 0 to 5, with higher scores indicating worse outcomes. Photography and evaluation of treated area for scar formation will be assessed at outpatient follow-ups at approximately 30 days, 60 days, 90 days, 180 days, and 365 days post-discharge (with 2-4 weeks deviation). Follow-ups typically take place in-person at clinic visits, but may take place online via a secure platform.

Time of wound healingAcute hospitalization (1-4 months post admission depending on severity of injury)

Time from wound excision to 95% healing of the burned area will be recorded. Photography and evaluation of wounds will occur at enrollment, operation days, dressing take-downs, and discharge from hospital.

Quality of skin regeneration - Abnormal scar formationAcute hospitalization (1-4 months post admission depending on severity of injury)

The formation of hypertrophic scars or keloids will be recorded to assess the quality of skin regeneration. Photography and evaluation of wounds will occur at enrollment, operation days, dressing take-downs, and discharge from hospital.

Quality of skin regeneration - Arterial bleeding from the wound siteAcute hospitalization (1-4 months post admission depending on severity of injury)

Arterial bleeding from the wound site will be recorded to assess the quality of skin regeneration. Photography and evaluation of wounds will occur at enrollment, operation days, dressing take-downs, and discharge from hospital.

Quality of skin regeneration - Detachment of Integra®-SCAcute hospitalization (1-4 months post admission depending on severity of injury)

The detachment of the entire Integra®-SC from the wound site will be recorded to assess the quality of skin regeneration. Photography and evaluation of wounds will occur at enrollment, operation days, dressing take-downs, and discharge from hospital.

Scar formation - Pigmentation of the healed areaDischarge to 1 year post-discharge

Pigmentation of the healed area is assessed as part of the Vancouver Scar Scale to evaluate scar formation over time. Pigmentation is scored from 0 to 2, with higher scores indicating worse outcomes. Photography and evaluation of treated area for scar formation will be assessed at outpatient follow-ups at approximately 30 days, 60 days, 90 days, 180 days, and 365 days post-discharge (with 2-4 weeks deviation). Follow-ups typically take place in-person at clinic visits, but may take place online via a secure platform.

Scar formation - Height of the healed areaDischarge to 1 year post-discharge

The height of the healed area is assessed as part of the Vancouver Scar Scale to evaluate scar formation over time. Height is scored from 0 to 3, with higher scores indicating worse outcomes. Photography and evaluation of treated area for scar formation will be assessed at outpatient follow-ups at approximately 30 days, 60 days, 90 days, 180 days, and 365 days post-discharge (with 2-4 weeks deviation). Follow-ups typically take place in-person at clinic visits, but may take place online via a secure platform.

Trial Locations

Locations (1)

Hamilton General Hospital

🇨🇦

Hamilton, Ontario, Canada

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