Management of Complex Wounds Using a Constant Tension External Tissue Expander
| Status: | Terminated |
|---|---|
| Conditions: | Hospital |
| Therapuetic Areas: | Other |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | July 2010 |
| End Date: | September 2015 |
Complex wounds that cannot be closed primarily are at great risk for complications. A new
technique utilizing external tissue expansion holds promise in rapidly decreasing wound
area. Facilitation of rapid wound closure is critical in preventing wound complications.
Hypothesis:
Using the Dermaclose Wound Management System (Woundcare Technologies, Inc., Chanhassen, MN)
in complex wounds not able to be primarily closed will decrease the time to secondary
closure and decrease the need for secondary soft tissue coverage procedures, or if secondary
soft tissue procedures are required, its use will decrease the size and complexity of the
secondary soft tissue procedures.
Null Hypothesis:
The Dermaclose system will not decrease the need, dimensions, or complexity of secondary
soft tissue coverage procedures in complex wounds not able to be primarily closed.
technique utilizing external tissue expansion holds promise in rapidly decreasing wound
area. Facilitation of rapid wound closure is critical in preventing wound complications.
Hypothesis:
Using the Dermaclose Wound Management System (Woundcare Technologies, Inc., Chanhassen, MN)
in complex wounds not able to be primarily closed will decrease the time to secondary
closure and decrease the need for secondary soft tissue coverage procedures, or if secondary
soft tissue procedures are required, its use will decrease the size and complexity of the
secondary soft tissue procedures.
Null Hypothesis:
The Dermaclose system will not decrease the need, dimensions, or complexity of secondary
soft tissue coverage procedures in complex wounds not able to be primarily closed.
Upon IRB approval, 50 patients with complex soft tissue wounds, with or without an
associated fracture that cannot be closed primarily will have the Dermaclose device applied
and will be prospectively followed for 1 year. The Dermaclose device will be applied
according to the manufacturer's guidelines. This device may be combined with the use of
Negative Pressure Wound Therapy. Primary and secondary end points that were initially
intended to be included are listed below. However, on SF12 and pain outcome measures were
collected and reported.
Initially Intended Primary end points (only SF12 collected and reported):
SF12
1. Initial and final wound dimensions
2. Secondary soft tissue coverage procedures
3. Dimensions and type of secondary soft tissue coverage procedures required compared to
initial wound dimensions
4. Method of wound closure
5. Days to wound closure
6. Number and types of procedures required for wound closure
7. Infection requiring reoperation
8. Wound dehiscence requiring reoperation
Initially intended Secondary end points (only #3 collected and reported):
1. Superficial wound dehiscence not requiring reoperation
2. Superficial wound infection not requiring reoperation
3. Visual Analog Pain Scale (VAS) with Dermaclose use
4. Use of negative pressure wound therapy
5. Cost-to-benefit ratio of Dermaclose use - hospital days, number of procedures,
procedural and hospital costs including device, negative pressure wound therapy costs,
and operating room time and associated costs
Patients will be evaluated daily during their inpatient hospital stays for VAS related to
the wound for which the Dermaclose device is used. If the Dermaclose device is used on an
outpatient basis, the patient will be asked to complete a daily VAS at the same time to
monitor pain associated with device use. After hospital discharge, the patients will be
evaluated at 2 weeks, 6 weeks, 3 months, 6 months, and 12 months. They will complete an
SF-12 as part of the above evaluations. Patients may be evaluated at more frequent intervals
if the need arises. Primary and secondary endpoints will be evaluated at each time point.
associated fracture that cannot be closed primarily will have the Dermaclose device applied
and will be prospectively followed for 1 year. The Dermaclose device will be applied
according to the manufacturer's guidelines. This device may be combined with the use of
Negative Pressure Wound Therapy. Primary and secondary end points that were initially
intended to be included are listed below. However, on SF12 and pain outcome measures were
collected and reported.
Initially Intended Primary end points (only SF12 collected and reported):
SF12
1. Initial and final wound dimensions
2. Secondary soft tissue coverage procedures
3. Dimensions and type of secondary soft tissue coverage procedures required compared to
initial wound dimensions
4. Method of wound closure
5. Days to wound closure
6. Number and types of procedures required for wound closure
7. Infection requiring reoperation
8. Wound dehiscence requiring reoperation
Initially intended Secondary end points (only #3 collected and reported):
1. Superficial wound dehiscence not requiring reoperation
2. Superficial wound infection not requiring reoperation
3. Visual Analog Pain Scale (VAS) with Dermaclose use
4. Use of negative pressure wound therapy
5. Cost-to-benefit ratio of Dermaclose use - hospital days, number of procedures,
procedural and hospital costs including device, negative pressure wound therapy costs,
and operating room time and associated costs
Patients will be evaluated daily during their inpatient hospital stays for VAS related to
the wound for which the Dermaclose device is used. If the Dermaclose device is used on an
outpatient basis, the patient will be asked to complete a daily VAS at the same time to
monitor pain associated with device use. After hospital discharge, the patients will be
evaluated at 2 weeks, 6 weeks, 3 months, 6 months, and 12 months. They will complete an
SF-12 as part of the above evaluations. Patients may be evaluated at more frequent intervals
if the need arises. Primary and secondary endpoints will be evaluated at each time point.
Inclusion Criteria:
- Age 18 or greater
- Has soft tissue wound(s) that are unable to be closed primarily
Exclusion Criteria:
- Age less than 18
- Has wound(s) that can be closed primarily
- Infected wound
- Unable to comply with protocol
- Prior radiation treatment to skin or soft tissues in the area of the wound
- Friable wound margins
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