The Sorbact® Antimicrobial Dressing in the Holistic Wound Management Of Diabetic Foot ulCers (Phase III Study) (ADHOC)
Foot Ulcer, Diabetic
About this trial
This is an interventional treatment trial for Foot Ulcer, Diabetic focused on measuring Sorbact, Best local Cares, DFU
Eligibility Criteria
Inclusion Criteria:
- Written consent to participate obtained.
- Male or female patient aged at least 18 years without superior limit.
- Type 1 or 2 diabetes.
- Less than one month HbA1c <=10%.
- Presence, on at least one foot, of a full-thickness ulcer for at least 4 weeks (location below the malleola).
- Neuropathy confirmed by insensitivity to monofilament (Semmes-Weinstein 5.07 monofilament according to diagnosis criteria presented in appendix 05).
- No ulcer should present a moderate or severe infection at baseline. Concomitant treatment with systemic antibiotics at baseline is accepted if all ulcers meet none of the criteria defining moderate or severe infection.
- All ulcers are appropriately debrided (less than 10% black tissue covering wound area on a colorimetric scale, adequate removal of hyperkeratosis).
- All ulcers are of Grade 1 or 2 of the Wagner classification.
Ulcers should meet one of the following criteria:
If only one ulcer is present, its largest diameters has to be ≥1 cm or this ulcer is categorized as grade 2 according to Wagner classification If more than one ulcer is present, the sum of all largest diameters has to be ≥2 cm or one ulcer is categorized as grade 2 according to Wagner classification
For both legs: ABPI ≥0.6 and <1.3 AND ankle systolic pressure ≥70 mmHg or systolic toe pressure ≥50 mmHg or TcPo2 ≥30 mmHg (decubitus).
If ABPI ≥1.3, patent femoral artery inflow should be confirmed by digital angiography, magnetic resonance, or CT angiography or doppler ultrasonography <6 months before randomization.
- Patient compliant to one of the accepted off-loading system.
Exclusion Criteria:
- Previous history of major amputation (cf. § 10.3.3.2 for definition) or planned major amputation within the first month after randomization.
- Revascularization procedure of lower leg, or any other treatment (e.g. neurostimulation) of any leg <8 weeks before randomization.
- Patient unable to be treated with one of the accepted type of off-loading system.
- Active Charcot foot.
- Presence of any ulcer with evidence of skin cancer.
- Presence of another chronic wound (i.e. present for 4 weeks or more) not involving the foot or involving the foot but extending above malleolus.
- Patient suffering from any known active malignancy, other than basal-cell carcinoma and cervical carcinoma in situ, requiring any general, local, surgical or radiation therapy.
- Patient suffering from severe morbid obesity (BMI ≥50 kg/m2).
- Severe hypertension with systolic blood pressure ≥180 mm Hg or diastolic blood pressure ≥110 mm Hg (measured at two occasions separated by a 4 week period in a patient sitting for at least 5 min).
- Patient with a severe comorbid disorder, not expected to survive more than 12 months
- Acute cardiovascular events (e.g. myocardial infarction, stroke, recent coronary intervention) within 3 months before randomisation
- Patient who are in the exclusion period following a previous participation to another trial or who are currently participating to any concomitant study with any drug or device.
- Known intolerance to the tested medical device.
Sites / Locations
- Faculty of Medicine MU a FH St. Ann Brno
- Cardiologic and pediatric ambulance s.r.o.
- Institute for Clinical and Experimental Medicine
- Podiatrie - Ustredni vojenska nemocnice - Vojenska fakultni nemocnice Praha
- Bulovka Hospital
- Hôpital Cardio-vasculaire Louis Pradel
- CHRU LILLE Hôpital Claude Huriez
- CHRU Lapeyronie
- Hopital Civil
- Maison de santé protestante de Bordeaux Bagatelle
- Gdański Uniwersytet Medyczny
- Instytut Medycny Wsi
- Angiodiabetica
- Warszawski Uniwersytet Medyczny
- PODOS
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Sorbact®
Best local cares
The basic Sorbact® presentation is an antimicrobial, non-adhesive absorbent wound dressing. It consists of a highly absorbent hydropolymer matrix with an antimicrobial Sorbact® mesh (Sorbact® acetate fabric coated with dialkyl carbamoyl chloride - DACC) and is covered by a semipermeable polyurethane film.
Dressing requirements in this study have to be consistent with international guidelines.