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Head and Neck CancerNCT02980601

The Use of Integra in Coverage of Radial Forearm Free Flap Donor Site Defect

A study testing Integra plus STSG and STSG in people with Head and Neck Cancer, run by Wake Forest University Health Sciences at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The purpose of this research study is to compare the forearm free flap of patients with a traditional split thickness skin graft and those repaired with Integra (a skin substitute that helps to provide wound closure) and a split thickness skin graft. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Head and Neck Cancer
What is being tested?
Integra plus STSG and STSG
Could I receive a placebo?
No, everyone receives an active treatment
How many people
10 participants
Where
1 siteUnited States
Study dates
Nov 2015to 6 Aug 2018
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • All subjects who receive a radial forearm free flaps in the included time period, including subjects with head and neck cancer, traumatic defects, chronic wounds, or any other problems that require a radical forearm free flap for reconstruction.
  • Have had a distal, anterograde fasciocutaneous flap
  • Age ≥ 18 years
  • Ability to understand and the willingness to sign an IRB-approved informed consent document.
  • Smokers and tobacco users will be included in this study

Who cannot join

  • Subjects who have had an osteocutaneous or musculocutaneous flap.
  • Subjects who have a radial forearm flap with a proximal skin flap or subjects that receive a "reverse" radial forearm flap
  • Pregnant women will be excluded due to the lack of clinical studies evaluating INTEGRA template in pregnant women.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Wake Forest University Health Sciences

    Winston-Salem, North Carolina, 27157

Other trials in United States

About this study

The purpose of this research study is to compare the forearm free flap of patients with a traditional split thickness skin graft and those repaired with Integra (a skin substitute that helps to provide wound closure) and a split thickness skin graft. The study team will be looking at the subject's satisfaction with how the skin graft site looks and how well the skin graft site is functioning.

Read the detailed description

The radial forearm fasciocutaneous free flap (hereafter referred to as RFFF) was described more than 30 years ago as a fasciocutaneous flap for microsurgical transfer. It was soon after established as a safe and reliable flap for transfer of fascia and cutaneous tissue. Currently, it is used to repair any defect in which a relatively thin island of skin is needed with a fascial strength layer . While the flap itself is very reliable, it leaves a donor site that can be very unsightly and has multiple known complications including loss of pronation, pain, paresthesias, cold intolerance, and skin graft necrosis. The donor site is typically covered with a split thickness skin graft (hereafter referred to as STSG). In an effort to minimize these complications, several groups have described a technique of placing Integra© dermal substitute (hereafter referred to as Integra) underneath the STSG to provide a thicker support and decrease overall morbidity associated with the defect. These studies have shown success in decreasing overall morbidity including increasing range of motion and improving aesthetic quality of the donor site. However, the largest study to date has included only 29 subjects. Furthermore, these studies do not provide a comparative cohort of subjects repaired with a classic STSG to show effectiveness of this technique when compared to a classic repair. Our goal is to perform a prospective study comparing subjects repaired with a classic STSG and those repaired with one step Integra and STSG applied at the same time. These subjects will be evaluated for overall donor site aesthetic quality and functional outcome as described below.

Being tested
Integra plus STSG, STSG
Keywords
Traumatic Defect, Chronic Wounds
Medical subject headings
Head and Neck Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Integra plus STSGDevice

    A sheet of Integra directly on the wound bed with subsequent removal of the overlying silicone sheet and immediate application of a 0.008mm STSG

  • STSGProcedure or surgery

    0.012mm STSG

Study groups in NCT02980601
Study groupRoleWhat they receive
Integra and a Split Thickness Skin Graft (STSG)ExperimentalA sheet of Integra directly on the wound bed with subsequent removal of the overlying silicone sheet and immediate application of a 0.008mm STSG.
Receives: Device: Integra plus STSG; Procedure: STSG
Split Thickness Skin Graft (STSG)Active comparatorreconstruction as dictated by the protocol. They will either receive 1) a 0
Receives: Procedure: STSG

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants With Skin Graft Necrosis.

    Number of participants with skin graft necrosis.

    Measured: 1 year

  2. Vancouver Scar Scale

    The Vancouver Scar Scale will measure donor site aesethetic quality and it encompasses 4 separate outcomes to be objectively assessed. Each has been separately reported in the literature for each group in different papers as previously mentioned. We will compare the final score as well as scores within each outcome.On a scale of 1-13; with higher score denoting worse outcome.

    Measured: 1 Year

  3. Vancouver Scar Scale - Pigmentation

    Pigmentation will be measured on the Vancouver Scar Scale. On a scale of 0-2; higher score denoting worse outcome.

    Measured: 1 year

  4. Vancouver Scar Scale - Vascularity

    Vascularity will be measured on the Vancouver Scar Scale. On a scale of 0-3; higher score denoting worse outcome.

    Measured: 1 year

  5. Vancouver Scar Scale - Pliability

    Pliability will be measured on the Vancouver Scar Scale. On a scale of 1-5; higher score denoting worse outcome.

    Measured: 1 year

  6. Vancouver Scar Scale - Height

    Height will be measured on the Vancouver Scar Scale. On a scale of 0-3; higher score denoting worse outcome.

    Measured: 1 year

  7. Hand Strength -Lateral Pinch

    Functional outcomes will be measured by using strength dynamometers.

    Measured: Pre-op

  8. Hand Strength -Lateral Pinch

    Functional outcomes will be measured by using strength dynamometers.

    Measured: 3 month

  9. Hand Strength -Lateral Pinch

    Functional outcomes will be measured by using strength dynamometers.

    Measured: 6 months

  10. Hand Strength -Lateral Pinch

    Functional outcomes will be measured by using strength dynamometers.

    Measured: 1 year

  11. Hand Strength - Grip

    Functional outcomes will be measured by using strength dynamometers.

    Measured: pre-op

  12. Hand Strength - Grip

    Functional outcomes will be measured by using strength dynamometers.

    Measured: 3 month

  13. Hand Strength - Grip

    Functional outcomes will be measured by using strength dynamometers.

    Measured: 6 month

  14. Hand Strength - Grip

    Functional outcomes will be measured by using strength dynamometers.

    Measured: 1 year

  15. Hand Strength- Pincer

    Functional outcomes will be measured by using strength dynamometers

    Measured: pre-op

  16. Hand Strength- Pincer

    Functional outcomes will be measured by using strength dynamometers

    Measured: 3 month

  17. Hand Strength- Pincer

    Functional outcomes will be measured by using strength dynamometers

    Measured: 6 month

  18. Hand Strength- Pincer

    Functional outcomes will be measured by using strength dynamometers

    Measured: 1 year

  19. Wrist Range of Motion- Flexion

    Functional outcomes will be measured by using electric goniometers so as to standardize the measurements. Wrist flexion and wrist extension

    Measured: pre-op

  20. Wrist Range of Motion- Flexion

    Functional outcomes will be measured by using electric goniometers so as to standardize the measurements. Wrist flexion and wrist extension

    Measured: 3 month

  21. Wrist Range of Motion- Flexion

    Functional outcomes will be measured by using electric goniometers so as to standardize the measurements. Wrist flexion and wrist extension

    Measured: 6 month

  22. Wrist Range of Motion- Flexion

    Functional outcomes will be measured by using electric goniometers so as to standardize the measurements. Wrist flexion and wrist extension

    Measured: 1 year

  23. Wrist Range of Motion- Extension

    Functional outcomes will be measured by using electric goniometers so as to standardize the measurements. Wrist flexion and wrist extension

    Measured: pre-op

  24. Wrist Range of Motion- Extension

    Functional outcomes will be measured by using electric goniometers so as to standardize the measurements. Wrist flexion and wrist extension

    Measured: 3 month

  25. Wrist Range of Motion- Extension

    Functional outcomes will be measured by using electric goniometers so as to standardize the measurements. Wrist flexion and wrist extension

    Measured: 6 month

  26. Wrist Range of Motion- Extension

    Functional outcomes will be measured by using electric goniometers so as to standardize the measurements. Wrist flexion and wrist extension

    Measured: 1 year

  27. Number of Participant With Tendon Exposure

    Tendon exposure identified clinically.

    Measured: 6 month

  28. Rate of Tendon Exposure

    Tendon exposure identified clinically.

    Measured: 1 year

  29. Patient Scar Assessment- Paresthesia

    Presence of paresthesia on a 1-10 scale , higher score denote worse outcomes

    Measured: 3 month

  30. Patient Scar Assessment- Paresthesia

    Presence of paresthesia on a 1-10 scale , higher score denote worse outcomes

    Measured: 6 month

  31. Patient Scar Assessment- Paresthesia

    Presence of paresthesia on a 1-10 scale , higher score denote worse outcomes

    Measured: 1 year

  32. The Disabilities of the Arm, Shoulder and Hand (QuickDASH) Questionnaire)

    Functional outcome as measured by pre and post operative assessment on the QuickDASH scale. On a scale of 0-100; with higher score denotes worse outcome measure

    Measured: pre-op

  33. The Disabilities of the Arm, Shoulder and Hand (QuickDASH) Questionnaire)

    Functional outcome as measured by pre and post operative assessment on the QuickDASH scale. On a scale of 0-100; with higher score denotes worse outcome measure

    Measured: 3 month

  34. The Disabilities of the Arm, Shoulder and Hand (QuickDASH) Questionnaire)

    Functional outcome as measured by pre and post operative assessment on the QuickDASH scale. On a scale of 0-100; with higher score denotes worse outcome measure

    Measured: 6 month

  35. The Disabilities of the Arm, Shoulder and Hand (QuickDASH) Questionnaire)

    Functional outcome as measured by pre and post operative assessment on the QuickDASH scale. On a scale of 0-100; with higher score denotes worse outcome measure

    Measured: 1 year

  36. Percent of Wound Contracture

    Planimetry Software will be used to measure and determine percentage of wound contracture

    Measured: 3 month

  37. Percent of Wound Contracture

    Planimetry Software will be used to measure and determine percentage of wound contracture

    Measured: 6 month

  38. Percent of Wound Contracture

    Planimetry Software will be used to measure and determine percentage of wound contracture

    Measured: 1 year

  39. Skin Pliability

    Skin pliability will be measuredusing a Cutometer MPA 580. We plan to measure Pliability (Ua), Elasticity (Ue), Retraction (Ur). Viscoelasticity (Uv), and Extension (Uf).

    Measured: 1 year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Dec 2016 (estimated)
  2. Study startNov 2015
  3. Primary completion18 Aug 2017
  4. Study completion6 Aug 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
10 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02980601
Sponsor's protocol ID
IRB00031531
Other IDs
CCCWFU 99915A
Status last verified
May 2019
First submitted
29 Nov 2016
Last updated
24 May 2019
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Integra plus STSG and STSG in people with Head and Neck Cancer, run by Wake Forest University Health Sciences at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 24 May 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 24 May 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants With Skin Graft Necrosis. (time frame: 1 year). The study lists 39 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 May 2019.

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