Novel Offloading for Diabetic Foot Ulcers With PulseFlow: A Prospective Study

NCT02783066 | Completed Phase 2 Results

• 1 other identifier: H-37713
• Study Type: interventional
• Target: 16
• Locations: 1 country
• Sites: 1

Brief Summary

Diabetic foot ulceration (DFU) is a common and largely preventable complication of diabetes. While most of these ulcers can be treated successfully, some will persist and become infected. Ultimately, nearly one fifth of patients with infected lower-extremity diabetic ulcers will require amputation of the affected limb, resulting in staggering costs for both the patient and the healthcare system. Prevention by identifying people at higher risk is key for better clinical management of such patients. It is not uncommon for patients suffering from diabetes to have concomitant lower extremity edema or venous insufficiency and they subsequently may benefit from graduated compression. However, because of the common association of peripheral arterial disease (PAD) in patients with diabetes, most clinicians are reluctant to apply compressive dressings in fear of exacerbating the symptoms of PAD and possibility of gangrene. A novel low voltage, battery powered medical device, PulseFlow DF® (The Diabetic Boot Company, Ltd. UK) has endeavored to assist in the treatment of Diabetic Foot Ulcers. The device provides hybrid functionality i.e. mobile air bladder pump at plantar arch and offloading boot. The air bladder inflates to 160 mmHg for approx. 1 second then deflates back to atmospheric pressure, allowing the plantar vessels sufficient time to refill. The offloading boot design holds the foot and lower leg in a position that reduces shear and friction forces and provides a reduction in plantar pressure. The PulseFlow DF is designed to record how many hours of blood pumping it has delivered. This data will be downloaded at each clinic visit. The boot cannot pump blood around the participant's foot unless fitted correctly and the battery is charged up overnight. The purpose of this study is to conduct an interventional study study with N=15 diabetic subjects with active foot ulcers to assess whether PulseFlow foot compression device can help improve lower extremity perfusion, whilst improving balance and spatio-temporal parameters of gait. The key goals of the proposed project are to test whether a specially designed compression device can improve lower extremity perfusion, whilst also simultaneously improving the balance and walking performance. Investigators envision the use of this specially designed offloading device with compression capability will help reduce the incidence of diabetic foot ulcers in high-risk diabetic patients. In addition, investigators assumed the proposed device might enhance daily physical activity as well as walking performance. Investigators will conduct a prospective clinical study to validate these hypotheses. Potential changes in walking and spontaneous daily physical activities will be assessed using validated technologies that include walking analyzer system, balance assessment using body worn sensors, and computerized pressure insoles.

Conditions

Diabetic Foot Ulcer; Offloading

Outcome Measures

Primary Outcomes (2)

• Lower Extremity Perfusion Change From Baseline to 4 Weeks

  Skin perfusion measured in the ankle using Sensilase device. To measure Skin Perfusion Pressure (SPP), a pressure cuff is first automatically inflated to occlude arterial bed blood flow; this is verified by PAD-IQ by determining when perfusion has stopped. The pressure is then automatically released at a controlled rate while the cuff pressure and skin perfusion are measured. A graph displays pressure and perfusion during cuff deflation and indicates the pressure at which skin perfusion is found to return.

  baseline and 4 weeks

• Gait Speed Difference Between Pulseflow Offflaoding and Standard Offloading

  the quality of walking while wearing Pulseflow offflaoding compared to standard offloading

  baseline

Secondary Outcomes (9)

• Adherence

  4 weeks

• Wound Size Change From Baseline to 4 Weeks.

  baselineand and 4 weeks

• Stride Length Difference Between Pulseflow Offflaoding and Standard Offloading

  baseline

• Limp Difference Between Pulseflow Offflaoding and Standard Offloading

  baseline

• Peak Swing Angular Velocity

  baseline

Study Arms (1)

"PulseFlow" group

EXPERIMENTAL

Eligible subjects will try a new offloading boot for 4 weeks

Device: Offloading boot: PulseFlow

Interventions

Offloading boot: PulseFlow DEVICE

A new offloading boot, which may enhance balance, gait, and lower extremity blood flow

"PulseFlow" group

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• years old
• type II diabetes with active plantar ulcer,

You may not qualify if:

• Non-ambulatory or unable to stand without help or walk a distance of at least 6 feet without assistance
• Plantar ulcer on arch of the foot
• Patients with PAD (Ankle Brachial Index \< 0.5)
• Acute foot fracture
• Heart failure
• Pregnant women
• Patients on immunosuppressive drugs
• Participation in an interventional study in the last 30 days
• Major amputation
• Patients unable or unwilling to participate in all procedures and follow-up evaluations.

Sponsors & Collaborators

• Baylor College of Medicine: lead
• The Diabetic Boot Company: collaborator

Study Sites (1)

Baylor College of Medicine

Houston, Texas, 77030, United States

Location

MeSH Terms

Conditions

Diabetic Foot

Condition Hierarchy (Ancestors)

Diabetic Angiopathies; Vascular Diseases; Cardiovascular Diseases; Foot Ulcer; Leg Ulcer; Skin Ulcer; Skin Diseases; Skin and Connective Tissue Diseases; Diabetes Complications; Diabetes Mellitus; Endocrine System Diseases; Diabetic Neuropathies

Results Point of Contact

• Title: Prof.Bijan Najafi
• Organization: Baylor College of Medicine

bijan.najafi@bcm.edu

17137987536

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: NA
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor of Surgery

Study Record Dates

• First Submitted: May 19, 2016
• First Posted: May 26, 2016
• Study Start: January 1, 2016
• Primary Completion: June 30, 2019
• Study Completion: October 30, 2019
• Last Updated: August 12, 2020
• Results First Posted: August 12, 2020

Record last verified: 2020-07

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)