This is a prospective, randomised, open-label, within-patient controlled, non-inferiority clinical investigation of the nanofibrillar cellulose (NFC) wound dressing FibDex® for treatment of superficial dermal burns in paediatric and adult patients. The clinical performance and safety of FibDex® will be compared to Epicitehydro (QRSKIN GmbH, Würzburg, Germany) and Epiprotect® (S2Medical AB, Linköping, Sweden). Epicitehydro is considered to be the primary comparator. The investigation will be conducted at 2 clinical research sites in Sweden.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
7
Nanofibrillar cellulose wound dressing
Wound dressing
Wound dressing
Burn Centre, Uppsala University Hospital
Uppsala, Sweden
Non-inferiority of FibDex® compared to Epicitehydro in terms of time to clinical wound healing (days) defined as no need of any dressing (inner or outer)
At each clinical visit, the Investigator or delegate will assess and record in the eCRF if the inner dressing(s) has detached and judge whether or not there is a need for outer dressing.
Time frame: Within 2 to 3 weeks (until the wound has healed)
Non-inferiority of FibDex® compared to Epiprotect® in terms of time to clinical wound healing (days) defined as no need of any dressing (inner or outer).
At each clinical visit, the Investigator or delegate will assess and record in the eCRF if the inner dressing(s) has detached and judge whether or not there is a need for outer dressing.
Time frame: Within 2 to 3 weeks (until the wound has healed)
Non-inferiority FibDex® compared to Epicitehydro and Epiprotect®, respectively, in terms of re-epithelialisation of the initial wound area over time
Percentage of re-epithelialisation will be evaluated by visual observation by the Investigator or delegate and classified according following categories: \<50%, 50-75%, 76-90%, 90-95% and 96-100%.
Time frame: Within 2 to 3 weeks (until the wound has healed)
Evaluate degree of experienced pain
On Day 1, pain will be measured before application of FibDex® and the comparators and after outer layer dressing application. On the subsequent visits, pain will be measured before (background pain) and after (procedural pain) outer layer dressing change during the wound healing period. Patients aged ≥8 years will rate subjective pain using a Numeric Pain Rating Scale (NPRS) 0-10 (0 representing no pain and 10 representing the worst possible pain). Patients aged 4 to 7 years will rate pain using The Faces Pain Scale 0-10 (0 representing no pain and 10 representing very much pain). The Faces, Legs, Activity, Cry, Consolability (FLACC) 0-10 (0 is relaxed and comfortable and 7-10 is severe pain or discomfort or both) behavioural measurement will be used for assessment of pain in patients aged ≤3 years.
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Time frame: Within 2 to 3 weeks (until the wound has healed)
Assess clinical performance in terms of number of wound infections
The burn will be diagnosed with wound infection if at least 2 of the criteria based on the definition of burn wound infection stated by the American Burn Association, are fulfilled.
Time frame: Within 2 to 3 weeks (until the wound has healed)
Need for surgical intervention
If wounds, during subsequent dressing changes and assessments, is judged as not progressing in a favourable direction, or if time from trauma approaches/exceeds 2 to 3 weeks, surgical intervention should be considered.
Time frame: Within 2 to 3 weeks (until the wound has healed)
Assess clinical performance in terms of length of stay (days) at hospital
All patients hospitalised for their burns will be monitored by a research nurse. The day of discharge will be recorded in the eCRF. Any readmission after the initial discharge will also be noted in the eCRF and included in the total length of stay.
Time frame: Within 2 to 3 weeks (until the wound has healed)
Assess clinical performance in terms of number of outer layer dressing changes
Outer dressings will be changed at each visit (from Visit 3 and onwards) if deemed appropriate by the Investigator
Time frame: Within 2 to 3 weeks (until the wound has healed)
Evaluate scar quality
Burn scar outcome will be evaluated using the Patient and Observer Scar Assessment Scale (POSAS). For both the patient and the observer, the score for each item is added (1 - 10 where 10 indicates the worst imaginable sensation or scar and 1 corresponds to normal skin. Moreover, observer scale nominal variables, such as type of pigmentation, may be recorded in category boxes in addition to the 10 point scale. Lastly, the patient and observer score their "Overall Opinion" of the scar compared to normal skin with the same 10 point scale, where 1 is normal skin and 10 is the most markedly different scar.
Time frame: 3, 6 and 12 months post burn
Monitor Adverse Events (AEs)
Frequency, intensity and seriousness of AEs
Time frame: Within 2 to 3 weeks (until the wound has healed)
Monitor Device Deficiencies (DDs)
Frequency and nature of DDs
Time frame: Within 2 to 3 weeks (until the wound has healed)