PRF With Topical Antibiotics or Antiseptics in Chronical Wounds Version 1.4 (PRF-TAT)

  • STATUS
    Recruiting
  • End date
    Apr 18, 2027
  • participants needed
    120
  • sponsor
    Medical University of Vienna
Updated on 18 April 2022

Summary

Platelet rich fibrin (PRF) is a new therapy option for chronic wounds with yet unproven therapeutic efficacy. This randomised controlled trial aims to provide evidence of the efficacy of PRF as monotherapy as well as a growth promoting carrier matrix for antimicrobial compounds. The investigators therefore designed a four armed trial with three PRF arms which are compared to each other as well as to an active comparator. The treatment arms are as

follows

Study arm 1: PRF with amikacin and teicoplanin Study arm 2: PRF with placebo (0.9% sodium chloride) Study arm 3: PRF with PHMB (polyhexanid) plus Macrogolol (Lavasorb®) Study arm 4: Acticoat 7® wound dressing as active control Patients with infected chronic wounds may be included in this trial. Infection shall be diagnosed by an experienced senior infectious diseases specialist. Patients with untreated peripheral vascular occlusive disease as defined by an ABI (ancle brachial index) of < 0,7 are excluded from the trial as are patients with an uncontrolled diabetes mellitus or patients who have not received sufficient treatment for a diabetic foot syndrome. Any underlying illness will be treated following standard of care. In case of chronic venous insufficiency four-layered compression bandages will be applied each visit if tolerated by the patient. Alternatively compression stockings (Class III) are permitted. This is mentioned as "Disease specific treatment" in the protocol.

Patients will receive treatment for 56 days. After 28 and 56 days the wound surface will be compared to the baseline. Infection parameters (c-reactive protein and leucocyte count) will be measured weekly. Evaluation of systemic antimicrobial therapy will be performed at each visit. Systemic antimicrobial therapy is started at the discretion of a senior infectious diseases specialist.

Details
Condition Chronic Skin Ulcer
Treatment PRF mixed with amikacin and teicoplanin, PRF mixed with PHMB plus Macrogolol, PRF plus normal saline, Silver gauze
Clinical Study IdentifierNCT02652169
SponsorMedical University of Vienna
Last Modified on18 April 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Males and females aged over 18 who are able to give informed consent
Chronic venous ulcer with localized non-systemic soft-tissue infection diagnosed by senior infectious diseases specialist based on US FDA Guidance for Industry Chronic cutaneous ulcer and burn wounds June 2006
slough and necrotic tissue
exsudate
smell
inflammation
presence of granulation tissue
pain
Wound size ≥ 5 cm2 and < 200 cm2

Exclusion Criteria

Non-treated diabetes mellitus, HbA1c > 12 mg/dl
Non treated (orthopaedic shoe) diabetic foot syndrome
ABI < 0,7
Wound size 15 cm2 and > 200 cm2
CRP > 5 mg/dl
Leucocytes > 15.000 /μl
Infection of another site
Infection of the ulcer with a pathogen with inherent resistance to amikacin and teicoplanin
Known osteomyelitis
Known erysipelas
Known phlegmon
Complicated deep tissue infection not solely treatable with PRF plus antimicrobial therapy in the opinion of a senior infectious diseases specialist
Planned systemic antimicrobial therapy
Active viral hepatitis (A/B/C) or active HIV infection or active syphilis
Increased sensitivity to amikacin or teicoplanin, PHMB or macrogolol
Increased sensitivity to tramexanic acid or batroxobin
Presence of neoplastic growth in the ulcer
Thrombocytopenic patients (<150.000 G/L)
Haemoglobin < 95 g/L
Known pregnancy or lactation
Severe renal impairment (creatinine clearance <30 ml/min)
History or clinical signs of impairment of the cochlea or vestibularis system
Neuromuscular diseases (i.e. Myasthenia gravis, Parkinson's disease)
Aminoglycoside treatment less than four weeks before inclusion
Other reasons opposing the study participation on the discretion of the investigators
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