Medaxis Debritom+: Advanced micro fluid jet therapy to clean and stimulate wound
Sharp Surgical Debridement: Scalpel or Curette to clean and debride wound
Additional Outer Dressing Application: Application of moisture retentive dressing, and a multi layer compression dressing
Offloading: Patient will be offloaded in a diabetic camboot after treatment, or total contact cast if patient cannot be fit with diabetic offloading boot
Fibracol Wound Dressing: Application of a collagen alginate dressing
Study summary
The purpose of this clinical investigation is to assess performance of the Medaxis Debritom+™ and to collect subject outcome data in the treatment of diabetic foot ulcers (DFU) vs Standard sharp debridement.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
Accepted
Inclusion Criteria:
* At least 18 years old.
* Presence of a diabetic foot ulcer (DFU) meets all of the following features: Wagner Grade 1 or 2 (see Appendix A for definitions), including wounds that extend to the ligament, tendon, joint capsule or fascia
* At least 50% below the medial aspect of the malleolus
* Without abscess or osteomyelitis
* The index ulcer will be the largest ulcer if two or more DFUs are present and will be the only one evaluated in the study. If other ulcerations are present on the same foot, they must be more than 2 cm distant from the index ulcer.
* The index ulcer (i.e. current episode of ulceration) has been present for greater than 4 weeks prior to SV1 and less than 1 year, as of the date the subject consents for study.
* The index ulcer is a minimum of 1.0 cm2 and a maximum of 25 cm2 at SV1 and TV1.
* Adequate circulation to the affected foot as documented by a dorsal transcutaneous oxygen measurement (TCOM) or a skin perfusion pressure (SPP) measurement of ≥ 30 mmHg, or an Ankle Branchial Index (ABI) between 0.7 and 1.3 within 3 months of SV1, using the affected study extremity. As an alternative arterial Doppler ultrasound can be performed evaluating for biphasic dorsalis pedis and posterior tibial vessels at the level of the ankle within 3 months of SV1.
* The index ulcer has been offloaded for at least 14 days prior to randomization.
* Females of childbearing potential must be willing to use acceptable methods of contraception (birth control pills, IUD's, barriers or abstinence) during the course of the study and undergo pregnancy tests.
* Subject understands and is willing to participate in the clinical study and can comply - with weekly visits.
* Subjects must have read and signed the IRB approved ICF before screening procedures are undertaken.
Exclusion Criteria:
* The index ulcer is deemed by the investigator to be caused by a medical condition other than diabetes.
* The index ulcer, in the opinion of the investigator, is suspicious for cancer or has a positive carcinoma diagnosis.
* Subjects with a history of more than two weeks of treatment with immune-suppressants (including systemic corticosteroids \>10mg daily dose), cytotoxic chemotherapy, or application of topical steroids to the ulcer surface within 1-month prior to first SV1, or who receive such medications during the screening period or who are anticipated to require such medications during the course of the study.
* Subjects taking a selective COX-2 inhibitor, such as Celecoxib, for any condition.
* Subjects on any investigational drug(s) or therapeutic device(s) within 30 days preceding SV1.
* History of radiation at the ulcer site (regardless of time since last radiation treatment).
* Index ulcer has been previously treated or will need to be treated with any prohibited therapies. (See Section 6.2.4 of this protocol for a list of prohibited medications and therapies).
* Subjects with a previous diagnose of HIV, Hepatitis C, or other contagious diseases
* Presence of any condition(s) which seriously compromises the subject's ability to complete this study or the subject has a known history of poor adherence with medical treatment.
* Osteomyelitis or bone infection of the affected foot as verified by x-ray, CAT Scan, or MRI within 30 days prior to randomization. (In the event of an ambiguous diagnosis, the Principal Investigator will make the final decision).
* Subject is pregnant or breast-feeding.
* Presence of diabetes with poor metabolic control as documented with an HbA1c \> 12.0 within 90 days of randomization.
* Subjects with end stage renal disease as evidenced by a serum creatinine ≥ 3.0 mg/dL within 6 months of randomization.
* Index ulcer has reduced in area by 20% or more after 14 days of SOC from SV1 to the TV1/randomization visit.
Primary outcome measure(s)
Proportion of wounds completely healed at or before 16 weeks — 16 weeks examine the time it takes the wound to heal over a 16 week period
Trial sites (6)
Facility
City
Region
Status
CCR Research
San Francisco
California
Doctors Research Network
South Miami
Florida
Foot and Ankle Associates of the Mid-Atlantic
Frederick
Maryland
Foot and Ankle Associates of the Mid-Atlantic
Raleigh
North Carolina
Lower Extremity Institute for Research and Therapy, LLC
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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