This clinical trial will be a multi-centric prospective, randomized controlled study with the commercial objective of evaluating the clinical efficacy of a battery-powered portable device that uses blue LEDs. The clinical study aims to compare the existing standard treatment for burned areas in which the autologous skin graft was not successful, with a protocol that includes the administration of the treatment with EmoLED for 5 consecutive weeks in addition to conventional therapy. The enrolled patients will have to be examined after 5 weeks of treatment, until complete healing and subsequently their scarring will have to be evaluated at 3 and 6 months after healing.
Burns are the fourth most common type of trauma in the world, after traffic accidents, falls and personal violence. Around 11 million people worldwide used medical treatment for burns in 2004. The risk of burns increases with the lowering of the socioeconomic status. Of these burn victims, about 2% need hospitalization and about 0.5% need to be hospitalized in specialized centers. In deep burns, the surgical procedure of autologous skin transplant (autograft) is almost always the preferred way to induce a re-epithelization of the injured area. The coverage of a deep burn with the graft is -depending on the case case- immediate, delayed a few days after excision or late, after a first phase of direct scarring. Numerous are the types of surgery as well as the sites of skin removal. The autologous graft, however, presents a not negligible probability of failure that leads to the total or partial detachment of the grafted skin; when this happens the healing process of the lesion (or a part of it) uncovered occurs by second intention but is not always easy to manage, as this process can be delayed or stopped by many factors. Known factors contributing to this are, for example, diabetes, infections, metabolic deficiencies and the advanced age of the subject, while others are still being studied. Therefore, proper wound management and dressing after surgery, trauma or disease is an important part of the healing process, not only to prevent the onset of infections or other complications, but also to accelerate wound healing itself with as little scarring as possible. This clinical study will be a multi-centric prospective, randomized controlled parallel group, superiority study, with the commercial objective of evaluating the clinical efficacy of a battery-powered portable device that uses blue LEDs. The Study aims, within the planned observation weeks, to clinically compare two groups of patients with deep burn injuries whose autologous skin graft has failed in part or totally. The objective is to determine any differences in outcome between the two groups considered and whether the therapy of the treatment group is a valid alternative to the current therapy in terms of reactivation and support of the reparative process, speed of healing and scarring. Group 1, the "Control" group, will follow the standard treatment provided by the hospital protocol; Group 2, the "Treated" one, will follow the standard treatment provided by the hospital protocol to which is added the treatment with the EmoLED device, scheduled between the cleansing and the dressing. The measurement of the difference in efficacy of the device between the two arms will be evaluated in terms of reactivation of the healing process, intended as the achievement of a re-epithelialization of at least 30%, speed (time) of healing and scarring (Vancouver scale). The clinical trial in question aims, therefore, to investigate whether the group of patients undergoing standard therapy with, in addition, the treatment with EmoLED reaches a higher percentage of reactivations of the healing process than the one of the control group, subjected to standard treatment. If confirmed, this result would imply significant gains in terms of speeding up hospital stay for those patients where autologous grafts have not been successful, therefore also in terms of reducing public health expenditure, not to mention that, if the improvement of scarring results were confirmed in the Treated group, it would increase the quality of life of patients with burn scars which often significantly impact on this parameter. The population subject of this trial is widely representative of the target population, as there are no particular exclusion criteria and the sites involved are structures of excellence in the treatment of burns and failed skin grafting areas.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
This treatment consists of irradiation with the blue light emitted by the device for one minute on the injured area. If the wound has a greater extension than the irradiated area, multiple repeated applications will be performed on adjacent areas, until the entire wound is covered.
The standard treatment consists of: cleansing and possible debridement of the wound, application of the topical treatment indicated for that phase of the wound, intended as the "standard of care" of the structure, and subsequent bandaging.
Medical University of Graz - Department of Surgery - Division of Plastic, Reconstructive and Aesthetic Surgery
Graz, Austria
AO for emergency "Cannizzaro" - Big Burns Center
Catania, Italy
Plastic Surgery - Centro Ustioni ASL3 Liguria - Hospital Villa Scassi
Genova, Italy
ASST Grande Ospedale Metropolitano Niguarda
Milan, Italy
Patient with an at least 30% area reduction
Percentage of patients in the two groups who, after 5 weeks of treatment, achieve a percentage reduction in the wound area of at least 30%.
Time frame: 5 weeks
Percentage surface change
Percentage of surface reduction of the wound in the five weeks of observation, in the two treatment groups.
Time frame: 5 weeks
Healing time
Time to achieve healing (indended as the complete re-epithelialization of the observed area), in the two treatment groups.
Time frame: 6 months
Scarring
Evaluation of the scarring outcome, using the Vancouver Scar Scale (VSS), three and six months after the complete healing, in the two treatment groups. In the Vancouver Scar Scale, which assesses 4 variables (vascularity, height/thickness, pliability, and pigmentation), "0" is the minimum value and the better outcome, and "13" is the maximum value and worse outcome.
Time frame: 6 months
Adverse events
Safety of treatment (number of related adverse events in the two groups).
Time frame: 6 months
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AO Cardarelli - UOC Big Burns Center - Reconstructive Plastic Surgery
Napoli, Italy
AOU Pisana - Sede di Cisanello - UO Burns Center
Pisa, Italy