Abstract

BackgroundLeg ulcers due to venous disease are chronic wounds that can take 6 or more months to heal. Growth factors have been used to try and improve this healing; however, many such studies have failed, and that is thought to be due to enzymes in the wound that degrade the growth factors and prevent them from working.ObjectiveThis is a proof-of-concept study that will evaluate the treatment of chronic leg ulcers with topically applied growth factors that are combined with a therapy to prevent their inactivation in the wound. This combined therapy has the potential to speed up the healing of these wounds and thereby improve the quality of life of patients and reduce the costs to the health system.MethodsThis will be a double-blind, placebo-controlled, randomized controlled proof-of-concept study comparing growth factor with protease inhibitor wound dressings to growth factors with standard wound dressings.ResultsThe project was funded by the Canadian Institutes for Health Research and enrollment is expected to be initiated in 2018. It is expected that results will be available in 2021.ConclusionsIt is expected that the results of this trial will inform as to whether modifying the wound environment through the use of protease inhibitors increases the effectiveness of topically applied growth factors in the healing of chronic wounds.Trial RegistrationClinicalTrials.gov NCT02845466; https://clinicaltrials.gov/ct2/show/NCT02845466 (Archived by WebCite at http://www.webcitation.org/6yOPhSBUA)

Highlights

  • venous leg ulcers (VLUs) and diabetic foot ulcer extracellular matrix (ECM) (DFU) are the most prevalent chronic wounds and have high rates of recurrence ranging from 16% at 1 year to 60% at 5 years for VLU [5,6] and greater than 50% after 3 years for DFU [2]

  • The cost attributed to chronic wound management in Canada is considerable [7] with more than Can $1 million per year estimated for each Canadian hospital to treat just pressure ulcers and surgical wound infections [8]

  • The total annual cost associated with DFU-related care was $547 million CAD, or $21,371 CAD annual cost per prevalent case in 2011 [3]

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Summary

Objective

This is a proof-of-concept study that will evaluate the treatment of chronic leg ulcers with topically applied growth factors that are combined with a therapy to prevent their inactivation in the wound. This combined therapy has the potential to speed up the healing of these wounds and thereby improve the quality of life of patients and reduce the costs to the health system

Conclusions
Introduction
Methods
Randomization Method
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