EO2 Oxygen Delivery To Study Success Rate of Surgically Closed Wounds
Paraules clau
Resum
Descripció
Surgical wound (e.g., post minor amputation, reconstruction surgery, or surgical incision) complications such as infection, dehiscence, necrotic tissue, surgical revision, and poor cosmesis are unfortunately highly prevalent in patients undergoing surgical interventions. In most cases surgical wounds are managed with a simple island dressing, orthopaedic wool padding and a light retention bandage. It could be argued that such low cost, traditional dressings are adequate for most surgical wounds. However, some patients with poor tissue integrity often require modern wound care products that offer additional benefits, in particular among those with vascular and poor tissue oxygenation problem. Poor tissue oxygenation and poor skin perfusion could lead to surgical wound complications such as wound infection, tissue necrosis, phantom pain, trauma and untimely surgical revision as well as major amputation.
In particular, the presence of non-viable, necrotic tissue (estimated to occur in 15-25% of cases) is significant as it can be responsible for delaying healing, prolonging the inflammatory response, mechanically obstructing contraction and impeding re-epithelialisation. It also provides a focus for wound infection and surgical revision.
The problem associated with necrotic tissue is not limited to limb amputation and could be seen in other surgical closures leading to excessive scar formation. Many of these scars can be problematic, being aesthetically unpleasant and causing discomfort. Blood supply is a significant factor in wound healing, and an area of the skin with rich supply of vasculature is known to heal to finer scars. Several studies have demonstrated that mild hypoxia (lack of transcutaneous oxygen) is present in early scars, moderate hypoxia in proliferative scars, and severe hypoxia in regressive scars. Oxygen levels then return to normal in mature scars, which is consistent along with the dynamic change in microvessel density. Therefore level of transcutaneous oxygen could be a determinant factor in formation of excessive scar formation.
Dressing materials are known to influence postoperative surgical wound healing and scar formation. A particular dressing that could promote wound hydration is key to ensure quick epithelialization and decrease excessive scar formation. The current standard of care in wound healing is to promote a moist wound environment by regular changing dressing and hydrate wound when needed. Some new advanced dressing and products have been also suggested with promising results in reducing excessive scar formation such as the use of silicone sheeting, hydrogel wound dressing, etc.
In this study, the investigators hypothesize that using novel oxygen diffusion dressing allows delivery tissue oxygenation via TransCu O2® Oxygen Delivery System will reduce the likelihood of necrotic tissue as well as severe incisional scar post-surgical closure by improving transcutaneous oxygen levels during wound healing process. TransCu O2 Oxygen Delivery System is a novel wound healing therapy that promises to enhance tissue hydration, which in turn may lead to quick epithelialization essential to reduce the likelihood of formation of necrotic tissue and excessive scars.
Dates
| Darrera verificació: | 12/31/2019 |
| Primer enviat: | 05/20/2019 |
| Inscripció estimada enviada: | 05/20/2019 |
| Publicat per primera vegada: | 05/22/2019 |
| Última actualització enviada: | 01/13/2020 |
| Publicació de l'última actualització: | 01/17/2020 |
| Data d'inici de l'estudi real: | 05/17/2017 |
| Data estimada de finalització primària: | 12/14/2020 |
| Data estimada de finalització de l’estudi: | 01/14/2021 |
Condició o malaltia
Intervenció / tractament
Device: Active
Fase
Grups de braços
| Braç | Intervenció / tractament |
|---|---|
| Active Comparator: Active Participants will be provided with a Transcu O2 ® Oxygen delivery system at the surgical site for 4 weeks as supportive care. | Device: Active Participants randomized into study active group will be provided with a Transcu O2® at their surgical site and followed for 4 weeks. |
| No Intervention: Control Participants will be placed in a standard dressing at the surgical site and will be followed for 4 weeks. |
Criteris d'elegibilitat
| Edats elegibles per estudiar | 18 Years Per a 18 Years |
| Sexes elegibles per estudiar | All |
| Accepta voluntaris saludables | Sí |
| Criteris | Inclusion Criteria: - 18-85 years of age. Ability to provide informed consent. - Presence of a wound due to surgical intervention and closure. - Subject or responsible caregiver is willing and able to maintain the required offloading (as applicable for the location of the wound) and applicable dressing changes Exclusion Criteria: - Charcot Arthropathy Bilateral AK/BK amputation Active Drug/alcohol abuse (or history of drug/alcohol abuse in last 1 month) Dementia or impaired cognitive function Subjects with osteomyelitis or extreme gangrene. Excessive lymphedema Presence of active infection Subject has a history of or any intercurrent illnesses or conditions that would compromise the safety of the subject according to judgement of a qualified wound specialist. |
Resultat
Mesures de resultats primaris
1. Self-reported pain change at every week [Baseline to 4 weeks]
2. Change in skin perfusion at baseline and 4 weeks [baseline to 4 weeks]
3. Change in wound size from baseline to 4 weeks [baseline to 4 weeks]
4. Incidence of complication from baseline to 4 weeks [baseline to 4 weeks]
5. Change in tissue oxygenation from baseline to 4 weeks [baseline to 4 weeks]
Mesures de resultats secundaris
1. Presence of scar tissue [baseline to 4 weeks]
