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Trial registered on ANZCTR
Registration number
ACTRN12621001099819
Ethics application status
Approved
Date submitted
19/03/2021
Date registered
18/08/2021
Date last updated
30/06/2024
Date data sharing statement initially provided
18/08/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
The Topical trial: Application of an anaesthetic medication to painful ulcers to evaluate the pain relief benefit and wound healing potential
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Scientific title
Topical Sevoflurane Trial
A feasibility trial to evaluate the efficacy and safety of topical sevoflurane applied to chronic non-healing ulcer wounds to determine its effect on pain control and wound healing.
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Secondary ID [1]
303742
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none
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Universal Trial Number (UTN)
U1111-1266-1676
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Trial acronym
TTT
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic painful non-healing Ulcers
321193
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Condition category
Condition code
Skin
318984
318984
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0
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Other skin conditions
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Direct topical irrigation of liquid sevoflurane to chronic painful non-healing ulcer beds.
Sevoflurane comes in liquid form 100% solution
The dose will be 1ml per square centermeter of ulcer wound. A maximum of 1 application per day- or as often as a patient requires a dressing change- ie once every 2 or 3 days- up to 30 days in total or until dressing and wound care treatment is completed- whichever comes first.
Mode of delivery is via syringe- irrigated gently- prior to wound cleaning and redressing. Application of medication should take 1 min or less. The application of sevoflurane will be the responsibility of the research staff and the wound care will be the responsibility of the nursing wound care team in the hospital setting or the primary care nurses in the community.
This will involve 6 patients who will receive a single dose only. This will need to show a benefit in pain relief in a single application and no major side effects.
Adherence to the protocol will remain with the research staff performing the intervention.
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Intervention code [1]
320053
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Treatment: Drugs
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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primary endpoint
Comparison of maximum pain score during dressing changes, measured by numerical rating scale, baseline dressing versus dressing with sevoflurane.
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Assessment method [1]
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Timepoint [1]
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At each dressing change from start of intervention and up to 30 days. Dressing changes can be daily or once every 2 or 3 days. This is dependant on the assessment of wound care nurses.
The study will not increase dressing change requirements for patients.
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Secondary outcome [1]
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secondary endpoint
Comparison of average pain score during the dressing changes, measured by numerical rating scale, during baseline dressing versus during dressing with sevoflurane.
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Assessment method [1]
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Timepoint [1]
393060
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Comparison of average pain score over the 24hr following the dressing changes, measured by numerical rating scale, after baseline dressing versus after dressing with sevoflurane.
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Eligibility
Key inclusion criteria
Inclusion Criteria:
18 Years or older
Have a chronic (>3mth) painful ulcer wound (excluding ulcers on the face and head)
Have the capacity to understand the purpose and requirements of the study
Adequate written and verbal language skills for all communication to be conducted in English.
Provide written consent
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion Criteria:
Requires surgical intervention for ulcer wound
Other topical pharmacological treatments required for the ulcer
Primary physician opposes study Intervention
Personal history or family history of malignant hyperthermia
Known allergy to Sevoflurane
Malignant ulcer
Painless ulcer
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Not applicable
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Not applicable
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
N/A
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Phase
Phase 4
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
This intervention must prove to be broadly effective in this patient population group for it to become a mainstream method of treatment of ulcers. With this in mind we expect to see dramatic improvement in a small population group, This small pilot trial aims to show the treatment is efficacious, safe and feasible before proceeding with this promising treatment into routine practise
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
30/09/2021
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Actual
27/11/2021
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Date of last participant enrolment
Anticipated
31/03/2022
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Actual
11/03/2022
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Date of last data collection
Anticipated
31/03/2022
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Actual
18/03/2022
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Sample size
Target
6
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Accrual to date
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Final
6
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Recruitment outside Australia
Country [1]
23549
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New Zealand
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State/province [1]
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Waikato
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Funding & Sponsors
Funding source category [1]
308122
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Hospital
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Name [1]
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Anaesthetic research department- Waikato hospital,
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Address [1]
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Waikato Hospital
Waiora building Level 4
Pembroke st 3240
Hamilton
New Zealand
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Country [1]
308122
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New Zealand
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Primary sponsor type
Hospital
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Name
Anaesthetic Research Department, Waikato Hospital
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Address
Waikato Hospital
Waiora building Level 4
Pembroke st 3240
Hamilton
New Zealand
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
308878
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Address [1]
308878
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Country [1]
308878
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
308108
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Southern Health and Disability Ethics Committee
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Ethics committee address [1]
308108
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Ministry of Health Health and Disability Ethics Committees PO Box 5013 Wellington 6140 Street address: 133 Molesworth Street Thorndon Wellington 6011
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
308108
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16/07/2021
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Approval date [1]
308108
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07/10/2021
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Ethics approval number [1]
308108
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Summary
Brief summary
Chronic ulcer wounds come from a variety of causes. Often they are a sign of advanced progression of chronic diseases such as peripheral vascular disease, diabetes and renal failure. Some ulcers are not amenable to a surgical intervention. Severe pain limits noninvasive treatment options including making it difficult to adequately debride any eschar (dead tissue) or unhealthy excess granulation tissue from the ulcer at the time of dressing changes, thus increasing the chance that the ulcer will become grossly infected, and reducing the likelihood that the ulcer will heal. Ulcers can remain unhealed for many months, which may lead to systemic infection or infection of deeper tissue (muscle or bone), worsening local tissue ischaemia and enlargement of the ulcer, and transition to a malignant process. Non-malignant ulcers are typically painful, sometimes foul smelling, and often require frequent dressing changes. These features highlight why a chronic ulcer may have a profound negative impact on a patient’s quality of life The available case reports indicate that topical sevoflurane is a promising, cost effective and safe treatment, however these are small case reports and further research is needed to show efficacy and safety across wider patient populations and to define the mechanism of action of topical sevoflurane in the setting of chronic painful ulcer management. Currently patients with ulcers with no surgical treatment option face painful non-invasive interventions and use of strong analgesics, including opioid medications. Opioids are typically only modestly effective at relieving ulcer pain and cause a range of significant adverse side effects. If proven, this treatment option will; make treatment of ulcers less painful for patients, reduce the negative impact of ulcers on a patients’ quality of life, decrease opioid use and the related adverse effects, and may increase the proportion of patients that achieve healing of their ulcers.
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Trial website
Nil
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Trial related presentations / publications
nil
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Public notes
nil
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Contacts
Principal investigator
Name
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Dr John Barnard
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Address
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Waikato Hospital
Waiora Building Level 4
Anaesthetic research department
Pembroke st 3240
Hamilton
New Zealand
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Country
109566
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New Zealand
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Phone
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+6421341974
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Fax
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N/A
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Email
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[email protected]
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Contact person for public queries
Name
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Jono Termaat
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Address
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Waikato Hospital
Waiora Building Level 4
Anaesthetic research department
Pembroke st 3240
Hamilton
New Zealand
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Country
109567
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New Zealand
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Phone
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+64274031939
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Fax
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N/A
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Email
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[email protected]
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Contact person for scientific queries
Name
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John Barnard
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Address
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Waikato Hospital
Waiora Building Level 4
Anaesthetic research department
Pembroke st 3240
Hamilton
New Zealand
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Country
109568
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New Zealand
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Phone
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+64 21341974
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Fax
109568
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N/A
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Email
109568
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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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.
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