NCT05251480

Brief Summary

The study will examine the effectiveness of a decellularized dermal matrix (i.e., DermGEN™) in improving wound healing, quality of life and associated costs of treatment of DFUs in First Nations people living in the Northwestern Ontario Communities. First Nations people with active diabetic foot (DFU) ulcer attending a wound care clinic located at the Rainy River district office. An interventional, two-arm, randomized, prospective study of (1) standard of care (control) vs. (2) DermGEN™ - a decellularized dermal matrix (treatment) will be used in the treatment and management of DFU. Patients will be randomized to each arm (n=60 per arm) based on power calculations using data from our Pilot study.

Trial Health

63
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
120

participants targeted

Target at P50-P75 for not_applicable diabetes-mellitus

Timeline
7mo left

Started Dec 2024

Typical duration for not_applicable diabetes-mellitus

Geographic Reach
1 country

1 active site

Status
not yet recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress70%
Dec 2024Dec 2026

First Submitted

Initial submission to the registry

November 3, 2021

Completed
4 months until next milestone

First Posted

Study publicly available on registry

February 22, 2022

Completed
2.9 years until next milestone

Study Start

First participant enrolled

December 30, 2024

Completed
1 year until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 30, 2025

Completed
11 months until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2026

Expected
Last Updated

July 3, 2024

Status Verified

July 1, 2024

Enrollment Period

1 year

First QC Date

November 3, 2021

Last Update Submit

July 2, 2024

Conditions

Keywords

Diabetic UlcerDiabetic Foot UlcerNon-healing WoundTissue EngineeringRegenerative MedicineDecellularized MatrixAcellular Dermal MatrixTissue AllograftIndigenous HealingAdvanced Wound Care

Outcome Measures

Primary Outcomes (15)

  • Mean and median reduction in wound area in the first 4 weeks

    Mean and Median reduction in wound area in comparison to Treatment day 0. Area measured with Silhouette® measurement camera.

    4 weeks

  • Proportion with complete healing in the first 8 weeks

    Proportion with complete healing in the first 8 weeks. (Complete healing is defined as 100% epithelialization without drainage.)

    8 weeks

  • Proportion with complete healing in the first 12 weeks

    Proportion with complete healing in the first 12 weeks. (Complete healing is defined as 100% epithelialization without drainage.)

    12 weeks

  • Incidence of adverse events.

    Number of adverse events observed for each arm divided by participants in each arm, reported as a percentage

    Reports included at any time up to and including 20 weeks post treatment.

  • Impact of Treatment on Wound - LUMT Score

    Impact of treatment as measured by Leg Ulcer Management Tool (LUMT) score. Comparing initial LUMT score on treatment day 0 to subsequent weeks.

    1 week

  • Impact of Treatment on Wound - LUMT Score

    Impact of treatment as measured by Leg Ulcer Management Tool (LUMT) score. Comparing initial LUMT score on treatment day 0 to subsequent weeks.

    2 weeks

  • Impact of Treatment on Wound - LUMT Score

    Impact of treatment as measured by Leg Ulcer Management Tool (LUMT) score. Comparing initial LUMT score on treatment day 0 to subsequent weeks.

    3 weeks

  • Impact of Treatment on Wound - LUMT Score

    Impact of treatment as measured by Leg Ulcer Management Tool (LUMT) score. Comparing initial LUMT score on treatment day 0 to subsequent weeks.

    4 weeks

  • Impact of Treatment on Wound - LUMT Score

    Impact of treatment as measured by Leg Ulcer Management Tool (LUMT) score. Comparing initial LUMT score on treatment day 0 to subsequent weeks.

    8 weeks

  • Impact of Treatment on Wound - LUMT Score

    Impact of treatment as measured by Leg Ulcer Management Tool (LUMT) score. Comparing initial LUMT score on treatment day 0 to subsequent weeks.

    12 weeks

  • Impact of Treatment on Wound - LUMT Score

    Impact of treatment as measured by Leg Ulcer Management Tool (LUMT) score. Comparing initial LUMT score on treatment day 0 to subsequent weeks.

    20 weeks

  • Impact of Treatment on Quality of Life (WoundQoL)

    Impact of treatment on Quality of Life using the WoundQoL questionnaire score. Comparison of score on treatment day 0 to subsequent weeks.

    4 weeks

  • Impact of Treatment on Quality of Life (WoundQoL)

    Impact of treatment on Quality of Life using the WoundQoL questionnaire score. Comparison of score on treatment day 0 to subsequent weeks.

    8 weeks

  • Impact of Treatment on Quality of Life (WoundQoL)

    Impact of treatment on Quality of Life using the WoundQoL questionnaire score. Comparison of score on treatment day 0 to subsequent weeks.

    12 weeks

  • Impact of Treatment on Quality of Life (WoundQoL)

    Impact of treatment on Quality of Life using the WoundQoL questionnaire score. Comparison of score on treatment day 0 to subsequent weeks.

    20 weeks

Secondary Outcomes (4)

  • Proportion with complete healing at any time point

    up to and including 20 weeks post initial treatment (Day 0)

  • Time to first-measured complete healing

    up to and including 20 weeks post initial treatment (Day 0)

  • Mean and median reduction in wound area at 8 weeks

    8 weeks

  • Mean and median reduction in wound area at 12 weeks

    12 weeks

Study Arms (2)

Standard of Care

ACTIVE COMPARATOR

The standard of care includes physical examination, wound debridement, total cast or offloading boot, non-adherent dressing (PolyMem®) for wound covering, weekly visit for ongoing assessment

Procedure: Standard of Care

DermGEN™

EXPERIMENTAL

A decellularized dermal matrix created from donated human skin. This arm will receive the same care as the Standard of Care control arm-physical examination, wound debridement, total cast or offloading boot, non-adherent dressing (PolyMem®) for wound covering, weekly visit for ongoing assessment-with the addition of DermGEN™ onto the wound at the first visit.

Other: DermGEN™

Interventions

debridement, wound dressings, offloading

Standard of Care

Decellularized human dermal matrix created from donated human skin

Also known as: Acellular Dermal Matrix
DermGEN™

Eligibility Criteria

Age18 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Participant and social support (e.g., family, caregiver) ready and willing to participate and comply with follow-up regime
  • Participant willing to be involved in self-care (e.g., keep dressing dry at home) required during treatment
  • Participant willing to wear Total Contact Cast (TCC) for wound off-loading during treatment
  • Participant or legal representative has read and signed the informed consent form
  • Documented stable Type I or II diabetes (HbA1C between 5.0 to 10 mmol/L within 1 month prior to Day 0)
  • Ulcer has been present for a minimum of 2 weeks as of Day 0
  • Ulcer area is ≥2 cm2 prior to debridement at Day 0 of study
  • Ulcer extends through dermis and into subcutaneous tissue but without exposure of muscle, tendon, bone or joint capsule
  • Ulcer is free of dead tissue and clinical infection, and is comprised of healthy vascular tissue suitable for skin grafting on Day 0
  • Adequate perfusion to the extremity determined by at least one of the following:
  • Palpable pedal pulses, Transcutaneous oxygen measurement at the dorsum of the foot ≥30 mm Hg, Ankle-brachial index ranging from 0.8 to 1.2, At least biphasic Doppler arterial waveforms at the dorsalis pedis and posterior tibial arteries

You may not qualify if:

  • The individual has any condition that seriously compromises their capacity to provide consent and answers questions related to this study.
  • Untreated infection of soft tissue or bone and/or autoimmune connective tissue disorders
  • Ulcer is over Charcot deformity (joints deformity of foot and ankle common in people with diabetes)
  • Body mass index ≥50 kg/m2
  • Ulcer is not classified as diabetes-related
  • Ulcer has tunnels or sinus tracts that cannot be completely debrided
  • Medical condition(s) that in the investigators' opinion make the patient inappropriate for study (e.g active liver disease)
  • Presence of malignant disease not in remission for 5 years or more
  • The individual is undergoing chemotherapy/radiation therapy
  • The individual received radiation therapy within 30 days of Day 0 of study
  • The individual is taking an immunosuppressant medication (e.g., corticosteroids, immunosuppression or cytotoxic agents), or is anticipated to require such agents during study
  • Presence of acute or chronic hepatitis, liver disease, anemia, serum albumin \<2.0 gm/dL, or has alkaline phosphatase or LDH at twice the normal upper limit
  • Obvious clinical signs and symptoms of ongoing tissue infection (i.e., cellulitis) or bone infection (i.e., osteomyelitis)
  • Female individuals are pregnant at time or intend to get pregnant during study time
  • The individual has known allergies to antibiotics, such as penicillin and streptomycin
  • +2 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Northwestern Ontario (NWO) Wound Care Centre of Excellence

Emo, Ontario, P0W 1C0, Canada

Location

Related Links

MeSH Terms

Conditions

Diabetes MellitusFoot UlcerDiabetic FootFoot Injuries

Interventions

Standard of Care

Condition Hierarchy (Ancestors)

Glucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System DiseasesFoot DiseasesSkin DiseasesSkin and Connective Tissue DiseasesLeg UlcerSkin UlcerDiabetic AngiopathiesVascular DiseasesCardiovascular DiseasesDiabetes ComplicationsDiabetic NeuropathiesLeg InjuriesWounds and Injuries

Intervention Hierarchy (Ancestors)

Quality Indicators, Health CareQuality of Health CareHealth Services AdministrationHealth Care Quality, Access, and Evaluation

Study Officials

  • Paul F Gratzer, Ph.D.

    Dalhousie University

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Idevania Costa, RN, NSWOC (S), Ph.D

CONTACT

Joanne Ogden, RN,NSWOC

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Masking Details
Masking cannot be accomplished as one intervention will require application of an advanced wound care product (DermGEN™) and the other arm (control) will not receive the intervention. This will be quite obvious to all.
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: An interventional, two-arm, randomized, prospective study of (1) standard of care (control) vs. (2) DermGEN™ - a decellularized dermal matrix (treatment) will be used in the treatment and management of DFU. Patients will be randomized to each arm (n=60 per arm) based on power calculations using data from our Pilot study.
Sponsor Type
INDUSTRY
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor

Study Record Dates

First Submitted

November 3, 2021

First Posted

February 22, 2022

Study Start

December 30, 2024

Primary Completion

December 30, 2025

Study Completion (Estimated)

December 1, 2026

Last Updated

July 3, 2024

Record last verified: 2024-07

Data Sharing

IPD Sharing
Will not share

Locations