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Amnion Wound Covering for Enhanced Wound Healing

Primary Purpose

Burns, Wound of Skin, Skin Wound

Status
Recruiting
Phase
Early Phase 1
Locations
United States
Study Type
Interventional
Intervention
Amnion Membrane Powder
SOC Wound Covering
Sponsored by
Wake Forest University Health Sciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Burns focused on measuring Human amnion membrane, Autologous skin graft, Scar Formation

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • The subject requires autologous primary skin graft with two donor sites in similar areas, each measuring at least 25 cm2 with the likely depth of 0.012 inches and separated by a 5 cm gap. It is preferable that the two sites be on right and left sides of the body, but it is not an exclusion if they must be on the same side.
  • Eligible primary wound sites may be traumatic or chronic, and will be at least 50 cm2 (that will receive the donor graft) to allow assessment of two separate experimental donor sites of 25 cm2.
  • The subject is between the ages of 18 and 85 years of age.
  • The subject is willing to complete all follow-up evaluations required by the study protocol.
  • The subject is to abstain from any other covering or treatment of the wound(s) for the duration of the study unless medically necessary.
  • The subject agrees to abstain from enrollment in any other interventional clinical trial for the duration of the study.
  • The subject and/or guardian is able to read and understand instructions and give informed, voluntary, written consent.
  • The subject is able and willing to follow the protocol requirements

Exclusion Criteria:

  • The subject's primary wound site is less than 50 cm2The subject's primary wound site is not deemed appropriate for skin graft based upon the investigator's clinical experience
  • The subject has a microbiologically proven pre-existing local or systemic bacterial infection.
  • The subject has been receiving a systemic antibiotic for more than 48 hours prior to grafting.
  • Unstable cardiac disorders within the past 6 months including angina, abnormal ECG, history of cardiac arrest, surgery and/or other interventional procedure.
  • Hepatic disease or altered liver function as defined by ALT or AST value >3 times the upper limit of normal and/or T. Bilirubin >1.5 mg/dL at screening
  • Renal disease or altered renal function as defined by serum creatinine > 2 mg/dL at screening, or end-stage renal disease.
  • Hemoglobin <10.0 or >19.0 g/dL
  • Known coagulopathy or platelet disorder, or INR > 1.6 , PTT > 38 sec; PLT < 50,000 at screening
  • The subject is known to have a pre-existing, chronic condition that, in the opinion of the Investigator, may interfere with wound healing including but not limited to: current malignancy, uncontrolled diabetes (HbA1c >8) or diabetic ulcers, autoimmune disease or other immunocompromised diseases, renal impairment or ESRD, liver disease, hematological

Sites / Locations

  • Wake Forest University Health SciencesRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Amnion membrane product treatment area

SOC Wound Covering treatment area

Arm Description

The prepared amnion membrane powder will be directly applied to the prepared donor wound site (Site A). The wound will then be covered with the SOC dressing.

The donor wound site (Site B) will be covered per SOC (Standard of care).

Outcomes

Primary Outcome Measures

Incidence of Donor Site Wound Closure
Wound closure for both amnion membrane product and SOC will be defined as skin re-epithelization without drainage or dressing requirements confirmed at two consecutive study visits 2 weeks apart.

Secondary Outcome Measures

Incidence of Donor Site Wound Healing
Wound Healing for both amnion membrane product and SOC will be assessed clinically confirmed at two consecutive study visits 2 weeks apart.
Presence of infection
The presence of infection will be evaluated in accordance with guidelines derived from Cutting and Harding using standard clinical measures.
Vancouver Scar Assessment Scale
Scar formation will be evaluated the Vancouver Scar Assessment Scale.The scale is composed by the following Sub scales (minimum and maximum ranges in parenthesis): Pigmentation (0-2), Vascularity (0-3), Pliability (0-5), Height (0-3). Total score 0-13. Lower score denotes better outcomes for total range and subscales.
Presence of Dermatitis
Allergic Response to Human Amnion Membrane Product Covering will be assessed clinically by the presence of dermatitis.

Full Information

First Posted
November 21, 2018
Last Updated
May 1, 2023
Sponsor
Wake Forest University Health Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT03754218
Brief Title
Amnion Wound Covering for Enhanced Wound Healing
Official Title
Phase 1 Study of Human Amnion Membrane Powder for Enhanced Wound Healing
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 1, 2019 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Wake Forest University Health Sciences

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this research study is to find our if human amnion membrane powder can be safely used as a covering for wounds and can improve the condition of skin graft donor sites. The amnion powder product is composed of "lyophilized" (freeze-dried), "gamma irradiation sterilized" (exposed to bacteria killing radiation) fragments of amniotic membrane.
Detailed Description
Extensive burns and full thickness skin wounds can be devastating to patients, even when treated with our current standard of care. There are an estimated 500,000 burns treated in the United States each year. Moreover, in the military environment, soldiers who suffer from extensive burn injuries on the battlefield may benefit from rapid treatments that result in complete closure and protection of the wounds. As such, there is a need for mobile platform technologies that allow fast treatment at the site where the injury occurred, or at the very least at the forward operating sites. This safety investigation of a human amnion membrane powder product for wound healing is a with-in patient-controlled study, enrolling 10 subjects undergoing donor skin graft harvest. The single-center study will include patients undergoing donor skin harvest such that two regions, of at least 25 cm2 and separated by at least a 5 cm gap, of donor site wounds in comparable skin locations, are available for covering with the amnion membrane product and the current institutional standard of care (SOC) covering. The proposed sterilized product is composed of lyophilized, gamma-irradiated powder made from amniotic membrane for topical application with the purpose of enhanced wound healing. The primary objective of the study is to evaluate the safety of a human amnion membrane product intended for enhanced wound healing. The secondary objective is efficacy as evidenced by complete wound closure relative to standard of care (SOC) treatment in a similar wound on the same subject at donor sites created for skin grafts at 14 days and 28 days postoperatively.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Burns, Wound of Skin, Skin Wound
Keywords
Human amnion membrane, Autologous skin graft, Scar Formation

7. Study Design

Primary Purpose
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
10 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Amnion membrane product treatment area
Arm Type
Experimental
Arm Description
The prepared amnion membrane powder will be directly applied to the prepared donor wound site (Site A). The wound will then be covered with the SOC dressing.
Arm Title
SOC Wound Covering treatment area
Arm Type
Active Comparator
Arm Description
The donor wound site (Site B) will be covered per SOC (Standard of care).
Intervention Type
Drug
Intervention Name(s)
Amnion Membrane Powder
Intervention Description
This sterilized product is composed of lyophilized, gamma-irradiated powder made from amniotic membrane for topical application with the purpose of enhanced wound healing.
Intervention Type
Procedure
Intervention Name(s)
SOC Wound Covering
Intervention Description
Institutional standard of care wound covering.
Primary Outcome Measure Information:
Title
Incidence of Donor Site Wound Closure
Description
Wound closure for both amnion membrane product and SOC will be defined as skin re-epithelization without drainage or dressing requirements confirmed at two consecutive study visits 2 weeks apart.
Time Frame
Week 4
Secondary Outcome Measure Information:
Title
Incidence of Donor Site Wound Healing
Description
Wound Healing for both amnion membrane product and SOC will be assessed clinically confirmed at two consecutive study visits 2 weeks apart.
Time Frame
week 12
Title
Presence of infection
Description
The presence of infection will be evaluated in accordance with guidelines derived from Cutting and Harding using standard clinical measures.
Time Frame
up to 26 Weeks
Title
Vancouver Scar Assessment Scale
Description
Scar formation will be evaluated the Vancouver Scar Assessment Scale.The scale is composed by the following Sub scales (minimum and maximum ranges in parenthesis): Pigmentation (0-2), Vascularity (0-3), Pliability (0-5), Height (0-3). Total score 0-13. Lower score denotes better outcomes for total range and subscales.
Time Frame
up to 26 Weeks
Title
Presence of Dermatitis
Description
Allergic Response to Human Amnion Membrane Product Covering will be assessed clinically by the presence of dermatitis.
Time Frame
Up to 26 Weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The subject requires autologous primary skin graft with two donor sites in similar areas, each measuring at least 25 cm2 with the likely depth of 0.012 inches and separated by a 5 cm gap. It is preferable that the two sites be on right and left sides of the body, but it is not an exclusion if they must be on the same side. Eligible primary wound sites may be traumatic or chronic, and will be at least 50 cm2 (that will receive the donor graft) to allow assessment of two separate experimental donor sites of 25 cm2. The subject is between the ages of 18 and 85 years of age. The subject is willing to complete all follow-up evaluations required by the study protocol. The subject is to abstain from any other covering or treatment of the wound(s) for the duration of the study unless medically necessary. The subject agrees to abstain from enrollment in any other interventional clinical trial for the duration of the study. The subject and/or guardian is able to read and understand instructions and give informed, voluntary, written consent. The subject is able and willing to follow the protocol requirements Exclusion Criteria: The subject's primary wound site is less than 50 cm2The subject's primary wound site is not deemed appropriate for skin graft based upon the investigator's clinical experience The subject has a microbiologically proven pre-existing local or systemic bacterial infection. The subject has been receiving a systemic antibiotic for more than 48 hours prior to grafting. Unstable cardiac disorders within the past 6 months including angina, abnormal ECG, history of cardiac arrest, surgery and/or other interventional procedure. Hepatic disease or altered liver function as defined by ALT or AST value >3 times the upper limit of normal and/or T. Bilirubin >1.5 mg/dL at screening Renal disease or altered renal function as defined by serum creatinine > 2 mg/dL at screening, or end-stage renal disease. Hemoglobin <10.0 or >19.0 g/dL Known coagulopathy or platelet disorder, or INR > 1.6 , PTT > 38 sec; PLT < 50,000 at screening The subject is known to have a pre-existing, chronic condition that, in the opinion of the Investigator, may interfere with wound healing including but not limited to: current malignancy, uncontrolled diabetes (HbA1c >8) or diabetic ulcers, autoimmune disease or other immunocompromised diseases, renal impairment or ESRD, liver disease, hematological
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Joseph Molnar, MD, PhD
Phone
13367164153
Email
JMolnar@wakehealth.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Mary Clare Day, RN
Phone
336-713-1343
Email
mday@wakehealth.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joseph Molnar, MD, PhD
Organizational Affiliation
Wake Forest University Health Sciences
Official's Role
Principal Investigator
Facility Information:
Facility Name
Wake Forest University Health Sciences
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
No
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Amnion Wound Covering for Enhanced Wound Healing

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