Please note that the copy function is not enabled for this field.
If you wish to
modify
existing outcomes, please copy and paste the current outcome text into the Update field.
LOGIN
CREATE ACCOUNT
LOGIN
CREATE ACCOUNT
MY TRIALS
REGISTER TRIAL
FAQs
HINTS AND TIPS
DEFINITIONS
Trial Review
The ANZCTR website will be unavailable from 1pm until 3pm (AEDT) on Wednesday the 30th of October for website maintenance. Please be sure to log out of the system in order to avoid any loss of data.
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
information for consumers
Download to PDF
Trial registered on ANZCTR
Registration number
ACTRN12612000500853
Ethics application status
Approved
Date submitted
24/04/2012
Date registered
9/05/2012
Date last updated
9/05/2012
Type of registration
Retrospectively registered
Titles & IDs
Public title
Type 1 Keystone Flap versus Simple Primary Closure for wound closure - A Prospective Randomised Controlled Trial
Query!
Scientific title
Type 1 Keystone Flap versus Simple Primary Closure for wound closure in patients undergoing surgical excision of skin lesion - A Prospective Randomised Controlled Trial
Query!
Secondary ID [1]
280386
0
None
Query!
Universal Trial Number (UTN)
Query!
Trial acronym
Query!
Linked study record
Query!
Health condition
Health condition(s) or problem(s) studied:
Wound closure of difficult surgical defects
286369
0
Query!
Condition category
Condition code
Surgery
286611
286611
0
0
Query!
Surgical techniques
Query!
Intervention/exposure
Study type
Interventional
Query!
Description of intervention(s) / exposure
Type 1 Keystone flap as described by F Behan. A type of Perforator island flap - that is a tissue island which is separated from surrounding skin and hence relies on deep perforating vessels for it's blood supply. It is essentially elliptical in shape with its long axis adjacent to the long axis of the defect. The flap is based on randomly located vascular perforators. The wound is closed directly, the mid-line area is the line of maximum tension and by V-Y advancement of each end of the flap, the ‘islanded’ flap fills the defect. This allows the secondary defect on the opposite side to be closed, exploiting the mobility of the adjacent surrounding tissue. The technique can be found in the book 'The Keystone Perforator Island Flap Concept' by Felix Behan (Churchill Livingstone Australia,
ISBN: 9780729539715. Approximate duration is 30-60 minutes.
Query!
Intervention code [1]
284751
0
Treatment: Surgery
Query!
Comparator / control treatment
Simple primary wound closure. Eliptical excision of lesion with approximation of two edges and closure with simple sutures. Duration is approximately 20-40 minutes.
Query!
Control group
Active
Query!
Outcomes
Primary outcome [1]
287022
0
ASEPSIS wound score. This is a previously validated post-operative wound score which measures erythema, wound discharge, use of antibiotics, re-operation/drainage, and separation to provide an overall score on which wound healing can be judged and compared.
Query!
Assessment method [1]
287022
0
Query!
Timepoint [1]
287022
0
Post-operatively at one, two, and four weeks. Again at six months.
Query!
Secondary outcome [1]
297225
0
Visual analogue pain score.
Query!
Assessment method [1]
297225
0
Query!
Timepoint [1]
297225
0
Post-operatively at one, two, and four weeks. Again at six months
Query!
Secondary outcome [2]
297345
0
Cosmesis score - photographs judged by patients and non-medical volunteers
Query!
Assessment method [2]
297345
0
Query!
Timepoint [2]
297345
0
Post-operatively at one, two, and four weeks. Again at six months.
Query!
Eligibility
Key inclusion criteria
Patients undergoing surgical excision of skin lesion of which closure is suspected to be difficult. Intra-operative tension measurements will be taken and patients then stratified into tension-level groups for analysis.
Query!
Minimum age
18
Years
Query!
Query!
Maximum age
100
Years
Query!
Query!
Sex
Both males and females
Query!
Can healthy volunteers participate?
No
Query!
Key exclusion criteria
Children, pregnant women, those unable to consent.
Query!
Study design
Purpose of the study
Treatment
Query!
Allocation to intervention
Randomised controlled trial
Query!
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Patients attending clinic will be assessed for suitability. Consent will be obtained at this time. Randomisation will occur at the time of surgery once excision has occurred. The computer generated randomisation schedule is kept by a third person not involved with the study who will provide allocation arms upon request.
Query!
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer generated block randomisation with random block sizes.
Query!
Masking / blinding
Open (masking not used)
Query!
Who is / are masked / blinded?
Query!
Query!
Query!
Query!
Intervention assignment
Parallel
Query!
Other design features
Query!
Phase
Not Applicable
Query!
Type of endpoint/s
Efficacy
Query!
Statistical methods / analysis
Query!
Recruitment
Recruitment status
Recruiting
Query!
Date of first participant enrolment
Anticipated
1/04/2012
Query!
Actual
Query!
Date of last participant enrolment
Anticipated
Query!
Actual
Query!
Date of last data collection
Anticipated
Query!
Actual
Query!
Sample size
Target
200
Query!
Accrual to date
Query!
Final
Query!
Recruitment in Australia
Recruitment state(s)
Query!
Funding & Sponsors
Funding source category [1]
285156
0
Self funded/Unfunded
Query!
Name [1]
285156
0
Query!
Address [1]
285156
0
Query!
Country [1]
285156
0
Query!
Primary sponsor type
Individual
Query!
Name
Dr Charles Douglas
Query!
Address
The Breast Centre
Lake Maquarie Specialist Medical Centre
6-8 Sydney Street
Gateshead
NSW 2290
Query!
Country
Australia
Query!
Secondary sponsor category [1]
284019
0
None
Query!
Name [1]
284019
0
Query!
Address [1]
284019
0
Query!
Country [1]
284019
0
Query!
Ethics approval
Ethics application status
Approved
Query!
Ethics committee name [1]
287172
0
Hunter New England Human Research Ethics Committee
Query!
Ethics committee address [1]
287172
0
HNEHREC Locked Bag 1 New Lambton 2305 NSW
Query!
Ethics committee country [1]
287172
0
Australia
Query!
Date submitted for ethics approval [1]
287172
0
Query!
Approval date [1]
287172
0
02/03/2012
Query!
Ethics approval number [1]
287172
0
12/02/15/4.04
Query!
Summary
Brief summary
Surgical defeects that are predicted to be difficult to close may be considered for type one ketstone closure. The theoretical advantage of this method is that the release of the longitudinal tension in the wound allows greater stretch along the transverse axis. There is no reliable evidence in the literature to prove that this is the case in human models, indeed in our small study the increase in transverse stretch enabled by longitudinal release was less than 1mm. With this in mind the advantage of a keystone flap over other wound closure techniques is unclear. We aim to compare the keystone flap with simple primary wound closure, with primary outcome measured as wound healing, using the ASEPSIS wound score. The type one keystone flap was first described by Behan in 2003, for use in "suitable defects over most areas of the body up to 2cm in width". Patients will be recruited into the study based upon this selction criteria and then randomised to keystone flap or primary closure. Short and longterm follow up centered around the ASEPSIS wound score will be used to compare wound healing in the two groups.
Query!
Trial website
Query!
Trial related presentations / publications
Query!
Public notes
Query!
Contacts
Principal investigator
Name
34107
0
Query!
Address
34107
0
Query!
Country
34107
0
Query!
Phone
34107
0
Query!
Fax
34107
0
Query!
Email
34107
0
Query!
Contact person for public queries
Name
17354
0
Dr Charles Douglas
Query!
Address
17354
0
The Breast Centre
Lake Maquarie Specialist Medical Centre
6-8 Sydney Street
Gateshead
NSW 2290
Query!
Country
17354
0
Australia
Query!
Phone
17354
0
+610249424600
Query!
Fax
17354
0
Query!
Email
17354
0
[email protected]
Query!
Contact person for scientific queries
Name
8282
0
Dr Charles Douglas
Query!
Address
8282
0
The Breast Centre
Lake Maquarie Specialist Medical Centre
6-8 Sydney Street
Gateshead
NSW 2290
Query!
Country
8282
0
Australia
Query!
Phone
8282
0
+610249424600
Query!
Fax
8282
0
Query!
Email
8282
0
[email protected]
Query!
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF