Multicentric RCT Comparing High Purity Type I Collagen-Skin Substitute vs dHACM in Treatment of Diabetic Foot Ulcers

NCT07046403 | Completed Results FDA Device

• 1 other identifier: AIMS/IEC/206/2025
• Study Type: interventional
• Target: 120
• Locations: 1 country
• Sites: 4

Brief Summary

This is a randomized controlled clinical investigation in patients suffering from diabetic foot ulcers at multiple centers. The study intends to compare patient outcome data using Standard of Care with Type-I Collagen-based Skin Substitute and Standard of Care with Dehydrated Human Amnion/Chorion Membrane.

Conditions

Diabetic Foot Ulcer (DFU)

Keywords

Diabetic Foot Ulcer; High Purity Type-I Collagen-Based Skin Substitute; Dehydrated Human Amnion/Chorion Membrane; Randomized Controlled Clinical Trial; Multicentric Study

Outcome Measures

Primary Outcomes (1)

• Percentage Change in Wound Area

  The primary outcome of the study will be the percentage change in wound area, assessed at 1, 2,3, and 4 weeks, and week 5 reported measured manually with digital photography.

  5 weeks

Secondary Outcomes (9)

• Histopathological Analysis

  5 days

• Histopathological Analysis - Capillary Density (Vessels Per mm²)

  5 days

• Percentage of Participants to Obtain Complete Wound Closure

  5 weeks

• Time to Achieve Complete Wound Closure

  5 weeks

• Percentage of Participants Achieving ≥50% Wound Healing

  5 weeks

Study Arms (2)

High Purity Type-I Collagen-based Skin Substitute and SOC

ACTIVE COMPARATOR

The SOC in this study is wound care covering with High Purity Type-I Collagen-based Skin Substitute applied weekly or as needed followed by a padded 3-layer dressing comprised of first layer - non-adherent and porous paraffin gauze (Cuticel), second layer - absorbent 4x4 gauze pads \& third layer - soft roll and compressive wrap (Crepe Bandage)

Device: High Purity Type-I Collagen-based Skin Substitute and SOC

Human Amnion/Chorion Membrane and SOC

ACTIVE COMPARATOR

The SOC in this study is wound care covering with Dehydrated Human Amnion/Chorion Membrane followed by a padded 3-layer dressing comprised of first layer - non-adherent and porous paraffin gauze (Cuticel), second layer - absorbent 4x4 gauze pads \& third layer - soft roll and compressive wrap (Crepe Bandage)

Device: Dehydrated Human Amnion / Chorion Membrane and SOC

Interventions

High Purity Type-I Collagen-based Skin Substitute and SOC DEVICE

The SOC in this study is wound care covering with High Purity Type-I Collagen-based Skin Substitute applied weekly or as needed followed by a padded 3-layer dressing comprised of first layer - non-adherent and porous paraffin gauze (Cuticel), second layer - absorbent 4x4 gauze pads \& third layer - soft roll and compressive wrap (Crepe Bandage)

High Purity Type-I Collagen-based Skin Substitute and SOC

Dehydrated Human Amnion / Chorion Membrane and SOC DEVICE

The SOC in this study is wound care covering with Dehydrated Human Amnion/Chorion Membrane followed by a padded 3-layer dressing comprised of first layer - non-adherent and porous paraffin gauze (Cuticel), second layer - absorbent 4x4 gauze pads \& third layer - soft roll and compressive wrap (Crepe Bandage)

Human Amnion/Chorion Membrane and SOC

Eligibility Criteria

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

You may qualify if:

• Subjects must be at least 18 years of age or older.
• Subjects must have a diagnosis of type 1 or 2 Diabetes mellitus.
• At randomization subjects must have a target diabetic foot ulcer with a minimum surface area of 1.0 cm2 and a maximum surface area of 10.0 cm2 measured post debridement using a ruler to measure wound area.
• The target ulcer must have been present for a minimum of 4 weeks and a maximum of 52 weeks of standard of care prior to the initial screening visit.
• The target ulcer must be located on the foot with at least 50% of the ulcer below the malleolus.
• The target ulcer must be full thickness on the foot or ankle that does not probe to bone.
• Adequate circulation to the affected foot as documented by any of the following methods performed within 3 months of the first screening visit:
• Transcutaneous Oxygen Measurement (TCOM) ≥30 mmHg Ankle-Brachial Index (ABI) between 0.7 and 1.3 Peripheral Vascular Resistance (PVR): Biphasic Toe-Brachial Index (TBI) ˃0.6 As an alternative, arterial Doppler ultrasound can be performed evaluating for biphasic dorsalis pedis and posterior tibial vessels at the level of the ankle of the target extremity.

You may not qualify if:

• The subject must consent to using the prescribed off-loading method for the duration of the study.
• The subject must agree to attend the twice-weekly/weekly study visits required by the protocol.
• The subject must be willing and able to participate in the informed consent process.
• Patients must have read and signed the IRB approved ICF before screening procedures are undertaken.
• A subject known to have a life expectancy of \<6 months.
• If the target ulcer is infected or if there is cellulitis in the surrounding skin.
• Presence of osteomyelitis or exposed bone, probes to bone or joint capsule on investigator's exam or radiographic evidence.
• A subject that has an infection in the target ulcer that requires systemic antibiotic therapy.
• A subject receiving immunosuppressants (including systemic corticosteroids at doses greater than 10 mg of Prednisone per day or equivalent) or cytotoxic chemotherapy.
• Topical application of steroids to the ulcer surface within one month of initial screening.
• A subject with a previous partial amputation on the affected foot is excluded if the resulting deformity impedes proper offloading of the target ulcer.
• A subject with a glycated hemoglobin (HbA1c) greater than or equal to 13% taken at or within 3 months of the initial screening visit.
• A subject with a serum creatinine ≥ 3.0mg/dL within 6 months of the initial screening visit.
• A subject with an acute Charcot foot, or an inactive Charcot foot, that impedes proper offloading of the target ulcer.
• Women who are pregnant or considering becoming pregnant within the next 6 months.

Sponsors & Collaborators

• Adichunchanagiri Institute of Medical Sciences, B G Nagara: lead
• Mysore Medical College and Research Institute: collaborator
• Rajarajeswari Dental College & Hospital: collaborator
• JSS Medical College Hospital: collaborator

Study Sites (4)

RajaRajeswari Medical College and Hospital

Bangalore, Karnataka, 560074, India

Location

Adichunchanagiri Institute of Medical Sciences

Mandya, Karnataka, 571448, India

Location

Mysore Medical College and Research Institute

Mysore, Karnataka, 570001, India

Location

JSS Medical College Hospital

Mysore, Karnataka, 570004, India

Location

Related Publications (8)

• Narayan N, Gowda S, Shivannaiah C. A Randomized Controlled Clinical Trial Comparing the Use of High Purity Type-I Collagen-Based Skin Substitute vs. Dehydrated Human Amnion/Chorion Membrane in the Treatment of Diabetic Foot Ulcers. Cureus. 2024 Dec 5;16(12):e75182. doi: 10.7759/cureus.75182. eCollection 2024 Dec.

  PMID: 39649230 BACKGROUND

• Wolfe EM, Mathis SA, de la Olivo Munoz N, Ovadia SA, Panthaki ZJ. Comparison of human amniotic membrane and collagen nerve wraps around sciatic nerve reverse autografts in a rat model. Biomater Biosyst. 2022 Apr 7;6:100048. doi: 10.1016/j.bbiosy.2022.100048. eCollection 2022 Jun.

  PMID: 36824162 BACKGROUND

• Mohammed YA, Farouk HK, Gbreel MI, Ali AM, Salah AA, Nourelden AZ, Gawad MMA. Human amniotic membrane products for patients with diabetic foot ulcers. do they help? a systematic review and meta-analysis. J Foot Ankle Res. 2022 Sep 14;15(1):71. doi: 10.1186/s13047-022-00575-y.

  PMID: 36104736 BACKGROUND

• DiDomenico LA, Orgill DP, Galiano RD, Serena TE, Carter MJ, Kaufman JP, Young NJ, Jacobs AM, Zelen CM. Use of an aseptically processed, dehydrated human amnion and chorion membrane improves likelihood and rate of healing in chronic diabetic foot ulcers: A prospective, randomised, multi-centre clinical trial in 80 patients. Int Wound J. 2018 Dec;15(6):950-957. doi: 10.1111/iwj.12954. Epub 2018 Jul 17.

  PMID: 30019528 BACKGROUND

• Huang Y, Kyriakides TR. The role of extracellular matrix in the pathophysiology of diabetic wounds. Matrix Biol Plus. 2020 Apr 22;6-7:100037. doi: 10.1016/j.mbplus.2020.100037. eCollection 2020 May.

  PMID: 33543031 BACKGROUND

• Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. 2005 Jan 12;293(2):217-28. doi: 10.1001/jama.293.2.217.

  PMID: 15644549 BACKGROUND

• Narayan N, Shivannaiah C, Gowda S. Evaluating the Efficacy of High-Purity Type I Collagen-Based Skin Substitute Versus Dehydrated Human Amnion/Chorion Membrane in the Treatment of Venous Leg Ulcers: A Randomized Controlled Clinical Trial. Cureus. 2025 Jul 30;17(7):e89031. doi: 10.7759/cureus.89031. eCollection 2025 Jul.

  PMID: 40747200 BACKGROUND

• Narayan N, Ramegowda YH, Raghupathi DS, Chethan S, Gowda S. Biological Skin Substitutes in Pressure Ulcers: High-Purity Type I Collagen-Based Versus Amnion/Chorion Membrane. Cureus. 2025 Aug 25;17(8):e90956. doi: 10.7759/cureus.90956. eCollection 2025 Aug.

  PMID: 40862036 BACKGROUND

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

Limitations and Caveats

The study utilized an open-label design, which may introduce performance and detection bias. The follow-up duration of 5 weeks was predetermined and may not allow full evaluation of long-term wound durability or recurrence. The study did not include a pre-planned economic or cost-effectiveness assessment. The study was conducted at selected clinical sites and enrolled a specific diabetic population as per the inclusion/exclusion criteria, which may restrict broader applicability of findings.

Results Point of Contact

• Title: Dr Naveen N
• Organization: Adichunchanagiri Institute of Medical Sciences

naveen_uno1@yahoo.co.in

+91-9980023372

Study Officials

• Prema Dhanraj, MS, MCh

  Rajarajeshwari Medical College and Hospital

  STUDY CHAIR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor & HoD, Department of Plastic Reconstructive & Aesthetic Surgery

Study Record Dates

• First Submitted: June 21, 2025
• First Posted: July 1, 2025
• Study Start: July 5, 2025
• Primary Completion: September 9, 2025
• Study Completion: October 3, 2025
• Last Updated: November 21, 2025
• Results First Posted: November 21, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share

Locations

IN (4)