Closure Obtained With Vascularized Epithelial Regeneration for DFUs With SkinTE® (COVER DFUs)

  • End date
    Sep 30, 2024
  • participants needed
  • sponsor
Updated on 22 October 2022
treatment regimen
diabetic foot
wound dressing


The purpose of this study is to assess the safety and efficacy of SkinTE for treatment of Wagner grade 2 diabetic foot ulcers.


This study is a prospective, multi-center, randomized controlled trial (RCT) designed to assess the safety and efficacy of SkinTE with standard of care (SOC) dressings compared to SOC dressings alone (wound debridement, collagen-alginate dressing, multi-layer compression dressings, and offloading) in the treatment of Wagner grade 2 diabetic foot ulcers (DFUs) ranging in size from 1 to 10 cm2. After being informed about the study and potential risks, all patients giving written informed consent who meet eligibility criteria will undergo a 2-week screening period of SOC. Patients meeting eligibility criteria following the screening period will be randomized in a single-blind manner (blinded evaluator with closure confirmed by a blinded adjudicator) in a 1:1 ratio to SkinTE with SOC or SOC alone. Patients will be followed weekly for 6 months for wound closure.

Condition Diabetic Foot
Treatment Control, SkinTE
Clinical Study IdentifierNCT05372809
Last Modified on22 October 2022


Yes No Not Sure

Inclusion Criteria

At least 18 years of age
Documented history of Type I or Type II Diabetes Mellitus requiring oral and/or insulin replacement therapy
Presence of a DFU Wagner 2 grade wound on any aspect of the foot, provided it is at or below the aspect of the medial malleolus. If two or more DFUs are present with the same grade, the index ulcer is the largest ulcer and the only one evaluated in the study
If other wounds are present on the same foot, they must be more than 2 cm distant from the index ulcer
Index ulcer (i.e. current episode of ulceration) has been present for greater than four weeks prior to the initial screening visit (SV1)
Index ulcer (post-debridement) is a minimum of 1.0 cm2 and a maximum of 10 cm2 at the first screening visit (SV1) and first treatment visit (RV1)
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) of ≥ 0.7 and ≤ 1.2 or Arterial Doppler with a minimum of biphasic flow or Toe Brachial Index (TBI) ≥ 0.75 at SV1, using the affected study extremity
Index ulcer and/or index ulcer limb may have had prior infection, but infection(s) must be adequately treated and controlled as defined by IDSA Guidelines PEDIS Grade level 1
The index ulcer has been offloaded with protocol defined offloading device throughout the study screening period for at least 14 days prior to randomization (SV1 through the first randomization visit (RV1))
Negative pregnancy test for females of childbearing potential (e.g., not postmenopausal for at least one year or surgically sterile)
Subject understands and is willing to participate in the clinical study and can comply with weekly visits and the follow-up regimen
Females of childbearing potential must agree to use effective methods of contraception (birth control pills, barriers, or abstinence) from screening through end of study (EOS) and undergo pregnancy tests
Properly obtained written informed consent
Subject must have stable living environment in order to manage offloading and wound care management
The index ulcer has a clean base and is free of necrotic debris at time of placement of treatment product

Exclusion Criteria

Index ulcer and/or index limb with presence of gangrene or unstable ischemia at screening (SV1)
Revascularization surgery on the lower extremity on which the index ulcer is located within 30 days of screening (SV1)
Index ulcer in the opinion of the investigator is suspicious for cancer and should undergo an ulcer biopsy to rule out a neoplasm of the ulcer
Subjects with history of radiation on the same limb as the index ulcer (regardless of time since last radiation treatment)
Subjects with exposed internal fixation on the same limb as the index ulcer (note: external fixation is allowed if deemed stable by the investigator)
Subjects on any investigational drug(s) or therapeutic device(s) within 30 days preceding the first screening visit (SV1)
Index ulcer treated within the last 30 days prior to screening with a prohibited treatment as defined in full protocol
Subjects with a history of more than two weeks treatment with immunosuppressants (including systemic corticosteroids > 10mg prednisone (or equivalent) daily dose), cytotoxic chemotherapy, or application of topical steroids to the index ulcer surface within one month prior to first screening visit, or who receive such medications during the screening period, or who are anticipated to require such medications during the study
Presence of any condition(s) which seriously compromises the subject's ability to complete this study or has a known history of poor adherence to medical treatment
In the opinion of the investigator, the subject is non-compliant with offloading or index ulcer dressing prior to randomization
Active Charcot's arthropathy of the index ulcer limb as verified by clinical evaluation, and/or imaging (x-ray or MRI) within 30 days prior to randomization
Subjects with chronic osteomyelitis and/or cellulitis on the same limb as the index ulcer as verified by clinical evaluation, and/or imaging (x-ray or MRI) within 30 days prior to randomization
Subject is pregnant or breast-feeding
Presence of diabetes with poor metabolic control as documented with an HbA1c ≥12.0 within 30 days of randomization (RV1)
Subjects with end stage renal disease as evidenced by an eGFR <30 mL/min/1.73m2 within 120 days of randomization
Index ulcer has reduced or increased in area by 30% or more after 14 days of SOC from SV1 to the RV1/randomization visit
Evidence of unstable human immunodeficiency virus (HIV), hepatitis B, and/or hepatitis C in the opinion of the investigator at first screening visit (SV1)
Documented history of New York Heart Association Class III or IV congestive heart failure or unstable cardiovascular disease requiring intervention within 60 days prior to screening
Requiring surgical intervention (excluding debridement) at the time of consenting and/or increased probability of requiring surgical intervention during study participation (note: non-invasive surgical intervention is allowed if, per the Principal Investigator, treatment will not affect subject's ability to participate in clinical trial)
Any clinically significant finding, in the judgment of the investigator, that would place the subject at health risk, impact the study, or affect the completion of the study
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