This study aims to evaluate the safety and effectiveness of an experimental biological dressing called TrophiPatch, applied to adults with chronic leg ulcers of diabetic or vascular orign. TrophiPatch contains stromal cells derived from a donor's fat tissue, which are purified and processed in a certified laboratory. These cells have shown wound-healing, anti-inflammatory and pro-angiogenic properties in preclinical studies. All 18 participants will receive a single application of TrophiPatch on their wound. The total study duration is up to 24 weeks, with 23 scheduled visits for follow-up and monitoring.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
18
Topical application of an allogeneic adipose-derived stromal cell patch
University Hospitals of Geneva
Geneva, Switzerland
RECRUITINGComposite safety outcome at week 12 from baseline
Composite outcome including any of the following events: deterioration of the ulcer, as measured by an increase of the ulcer size of \> than 20% at week 12 as compared to d0; and/or presence of spreading infection or systemic infections (criteria according to IWII); and/or presence of treatment-related irritative or allergic contact dermatitis (as per clinical diagnosis)
Time frame: Week 12
Number of patients with localised infection (TILI score ≥ 5) not suspicious for irritative or allergic contact dermatitis
Time frame: Week 12
Extent of pruritus, as determined by Numerical Rating Score (NRS).
Eleven numbers from 0 to 10 are displayed and patients are asked to pick the number corresponding to the intensity of their pruritus
Time frame: Week 12
Number of patients with hyper-cicatrisation
Clinical evaluation
Time frame: Week 12
Number of patients with pathologic scar
clinical evaluation of cheloid or hypertrophic scar
Time frame: Week 12
Number of patients developing donor-HLA antibodies
Time frame: Week 12
Weekly change in ulcer area till week 12
Standardised measurement of the wound area will be performed once weekly in the occasion of the first visit of the week using the SilhouetteTM camera. Change of wound area will be calculated by subtracting the surface area at week X to that measured at d0. This will be expressed as % of change with respect to d0.
Time frame: from enrolment to week 12
Number of completely healed and epithelised ulcers at week 12.
Visual inspection of the ulcer at week 12 and evaluation of the corresponding digital image as acquired via the Silhouette camera. The ulcer will be considered completely healed if presenting an epithelial layer and persisting for 2 weeks.
Time frame: Week 12
Weekly evolution of the wound bed score till week 12
The wound bed score consists of 8 key components: (a) healing edges (wound edge effect); (b) black eschar; (c) greatest wound depth/granulation tissue; (d) amount of exudate, edema, peri-wound dermatitis, peri-wound callus and fibrosis; and (e) a pink wound bed. Each of these components is scored individually.. The maximum score (best score) is 16. The minimum possible score (worst score) is 0.
Time frame: From enrolment to week 12
Evolution of the quality of blood perfusion of the wound
The quality of vascularisation and the measurement of local oxygen (transcutaneous oximetry - tcpO2) will be determined by laser doppler imaging
Time frame: Week 2 and week 12
Reduction in pain during the study period
Pain will be measured using the Visual Analog Scale (VAS), a 10-centimeter horizontal line anchored by two extremes: "no pain" (score = 0) and "worst imaginable pain" (score = 10). Participants will indicate their pain level by marking a point on the line. Higher scores indicate worse pain.
Time frame: From enrolment to week 12
Change in quality of life
Change in quality of life will be assessed using the Wound-QoL questionnaire, a validated 17-item instrument specifically designed for patients with chronic wounds. Scores range from 0 to 4, with higher scores indicating worse quality of life.
Time frame: Day 0 and week 12
Assessment of patient-relevant benefits during wound therapy
Assessment of patient-relevant benefits during wound therapy will be conducted using the Patient Benefit Index (PBI), specifically the validated short version (PBI-S 2.0) and the PBI for chronic wounds (PBI-W). The PBI includes two parts: the Patient Needs Questionnaire (PNQ), where patients rate the importance of treatment goals, and the Patient Benefit Questionnaire (PBQ), where they rate the extent to which these goals were achieved. A weighted algorithm combines these ratings into a global PBI score ranging from 0 (no benefit) to 4 (maximum benefit). A score ≥ 1 is considered a clinically relevant benefit, while a score ≥ 3 reflects a high patient-reported benefit. Higher scores indicate greater perceived benefit from the therapy.
Time frame: Day 0 and week 12
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