A Randomized, Controlled Trial Comparing the Use of a Biodegradable Temporizing Matrix to Cadaver Skin in the Reconstruction of Hidradenitis Suppurativa Excisions
Overview
- Phase
- Phase 4
- Intervention
- Not specified
- Conditions
- Hidradenitis Suppurativa
- Sponsor
- Joseph M. Still Research Foundation, Inc.
- Enrollment
- 10
- Locations
- 1
- Primary Endpoint
- Number of days between initial excision and split-thickness skin grafting
- Status
- Recruiting
- Last Updated
- 2 years ago
Overview
Brief Summary
This will be a prospective, interventional, single-center, randomized, controlled, comparative study comparing a total of 10 patients treated with BTM and SOC in wounds diagnosed with Hidradenitis suppurativa (5 in each group).
Detailed Description
The goal of enrollment will be up to 10 subjects, which is based on feasibility and access to suitable patients during the enrollment period. Subjects will be consented prior to any study procedure being performed. Surgical planning, approach and procedures will follow the standard of care (SOC) already established by the JMS Burn Center at Doctors Hospital Augusta surgical team. After an aggressive, wide excision, and thorough debridement and cleansing of the affected lesions will be performed. Photos of the prepared wound bed will be taken prior to study product placement of both wounds. To prepare the wound bed, study eligible patients will receive either the BTM or SOC to each of their wounds. BTM will be placed on the surgically prepared wound bed and fixated with sutures or staples, according to manufacturer's recommendations, local clinical practice, and the clinical judgement of the investigator. SOC will be placed according to manufacturer's recommendations, local clinical practice, and the clinical judgement of the investigator. Photos of the wound bed with the BTM/SOC study product in place will be taken. A mesh-type, non-adherent dressing (ConformantTM, Smith \& Nephew or something similar) will be placed over the study product to prevent shear and friction. An antimicrobial dressing to help prevent infection (such as ActicoatTM, Smith \& Nephew or SilverlonTM, Cura Surgical) may be used but must be used over both wounds. Adequate padding with gauze will be placed over the top of the non-adherent, or antimicrobial dressing, KerlixTM rolls will be used as the outer dressing and Ace wrap or Sepro net dressing may be used as needed to hold all in place. Negative Pressure Wound Therapy will also be used in conjunction with the BTM or SOC, (at the discretion and clinical judgment of the investigator) to help manage exudate and improve the contact of the BTM and SOC to the wound bed. Follow up will be in the wound clinic as per normal SOC on Day 7,14,21, etc., (+/-3 days), until assessment of the study site determines that the wound is ready for grafting. Subject will be processed for the autografting operative procedure as per normal SOC. Once in the OR, the research study team will capture pertinent surgical data related to the skin graft: level of excision, meshing ratio, type of fixation, type of cover dressing. Photos will be taken post debridement and after product placement. Post-op, the patient will continue to be seen in the clinic on a weekly basis and autograft take, and presence of shear, friction or infection will be documented. Long term follow up will take place at 3,6, and 12 months. Study sites will be assessed for scar quality using the POSAS scale. ROM will be assessed for subjects if the wounds were in the axillae region. AE/SAE surveillance will be continued throughout the study and at all study visits.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Is ≥18 years of age
- •Has presented to the Joseph M. Still Burn Center at Doctors Hospital Augusta or Advanced Wound Clinic for treatment of HS
- •Diagnosed with chronic Hidradenitis Suppurativa that requires a wide surgical excision in the following anatomical areas (e.g. groin, axillae, buttocks or inframammary folds)
- •Diagnosed with Hurley Stage 3 HS that requires wide surgical excision
- •Patient can still have micro-abscesses
- •Subject or their legally authorized representative is able to provide informed consent
- •Males or non-pregnant females. Females of childbearing potential (FCBP) must have a negative urine or serum pregnancy test at Baseline
- •Willing to comply with all study procedures and expects to be available for the duration of the study
- •Negative Pressure Wound Therapy is needed to stabilize and support study graft
Exclusion Criteria
- •Has a cardiac risk (NYHA Classification III)
- •Has active diagnosis of any autoimmune process, cancer, or organ failure that in the opinion of the investigator would prevent the subject from successfully participating in the study,
- •Has coagulopathy that in the opinion of the investigator, would place subject at an increased risk for bleeding.
- •Has a known hypersensitivity to polyurethane
- •Anticipates a level of non-compliance
- •Significant risk factors for poor wound healing
Outcomes
Primary Outcomes
Number of days between initial excision and split-thickness skin grafting
Time Frame: 6 weeks
To compare the mean days to wound coverage with split skin graft (STSG) after excision of HS between wounds treated with either BTM or SOC
Secondary Outcomes
- Incidence rates of Infection(6 weeks)
- Measuring range of motion in axillae subjects(12 months)
- Number of additional surgical procedures(6 weeks)
- Success rate of resolving infections(6 weeks)
- Recurrence rates of hidradenitis suppurativa(12 months)
- Percentage of autograft take(6 weeks)
- Scar Assessment using objective/subjective assessment tool(12 months)
- Total number of pieces used(6 weeks)
- Number of re-operations needed for disease reoccurrence(12 months)
- Total costs of rehabilitation for axillae subjects(12 months)
- Total cost of the treatment(12 months)