Evaluation of a New Device "Orthèse Diabète" in the Healing of Foot Ulcers in Diabetic Patients

N/ACompletedNCT01956162

Proteor Group118 enrolled

Overview

Multi-center trial, randomized in 2 parallel groups, open label, with a blinded adjudication committee (PROBE methodology), comparing "Orthèse Diabète" with "conventional" removable devices in terms of healing of ulcers. \- Primary objective: Evaluate the efficiency of "Orthèse Diabète" compared to "conventional" removable devices, in terms of the proportion of diabetic patients whose principal ulcer will heal completely at 3 months.

1. Secondary objectives 1. Proportion of patients whose principal ulcer will heal completely at 1, 2 and 6 months 2. Proportion of patients in whom all initial plantar ulcers will heal completely at 1, 2, 3 and 6 months 3. Percentage of area decrease of the plantar ulcers at 1, 2, 3 and 6 months 4. Time to healing of the principal ulcer 5. Appearance of new ulcers 6. Requirement for amputation 7. Incidence of the infectious complications 8. Adherence of wearing 9. Patient's satisfaction with the prescribed device 2. Population 1. 13 centers/116 patients monitored for a period of 6 months maximum 2. Experimental Group: "Orthèse Diabète" a plantar off-loading custom-made removable device 3. Control group: "Conventional" removable off-loading systems among the devices available in France.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

118

Conditions

Foot Ulcer, Diabetic

Interventions

Orthèse DiabèteDEVICE

The device ensures the discharge of the wound by the excavation of the orthopedic insole facing the wound and the load distribution in the healthy areas.

"Conventional" DeviceDEVICE

Standard (e.g.: CHUT, BAROUK, Tera-Diab, Sanital, Teraheel, Aircast boots, Walker Stabil D, etc.), or customized (orthopedic insole, Ransart boot, D.T.A.C.P., etc.) removable off-loading systems

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Type 1 or type 2 diabetic patients diagnosed according to the ADA experts consensus \[ADA 1997\] * Over 18 years of age * With a sensory neuropathy (abnormal 10 g monofilament test, i.e. not perceived at least 2 times in 1 of the 3 areas explored : pulp of the great toe, 1st and 5th metatarsal heads) * Without a severe arteriopathy defined by : ABI \< 0,7 and/or TcPO2 \< 30 mm Hg and/or big toe pressure \< 30 mm Hg * with one or more plantar ulcerations with an area \> 0,25 cm² or an amputation (toes or transmetatarsal) open or sutured * not requiring a contralateral off-loading device * Informed about the study and having given their informed and written consent to participate * registered with a social security scheme or with the CMU (beneficiary or entitled recipient) * having undergone a medical exam * not included in another protocol throughout the study Exclusion Criteria: * Severe skin or osteoarticular infection requiring a parenteral antibiotic therapy or surgery * Large ulcer of the ipsilateral leg \> 20 cm2 of area * Contralateral above heel amputation * Intercurrent disease prohibiting participation in the protocol * Weight over 130 Kg * Person under tutorship or under curatorship * Loss of functional and/or neuropsychological autonomy * Pregnant or likely to be pregnant woman

Locations (1)

Bichat Hospital

Paris, France

Outcomes

Primary Outcomes

Evaluate the efficiency of "Orthèse Diabète" compared to "conventional" removable devices, in terms of the proportion of diabetic patients whose principal ulcer will heal completely.

Evaluated by taking photographs, measuring the ulcer area (using Digital Photo Planimetry DPP and the software Tracer.exe). Full healing defined by the adjudication committee based on the analysis of the photographs.

Time frame: At 3 months

Secondary Outcomes

Proportion of patients whose principal plantar ulcer will be fully healed

Time frame: At 1, 2 and 6 months

Proportion of patients whose all initial plantar ulcers will be fully healed.

Time frame: At 1, 2, 3 and 6 months

Percentage decrease of the ulcer area

The area is evaluated by the last measurement undertaken during the trial or prior to a serious event (death, amputation, orthopedic or vascular surgery).

Time frame: At 1, 2, 3 and 6 months

Time to healing of the principal ulcer

Time frame: From the patient's off-loading device delivery visit to the date of healing validated by the adjudication committee

Appearance of new ulcers on the affected foot and/or contralateral

The following elements will be specified: cause, side, location, severity, treatment used

Data from ClinicalTrials.gov

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