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RECRUITING

NCT06388603

RCT on Bioactive Glass S53P4 in Diabetic Foot Osteomyelitis in the Forefoot (DFORCT)

Sponsor: ASST Ovest Milanese

View on ClinicalTrials.gov

Summary

The Study will be a prospective multicenter randomized trial, focused on the management of acute and chronic Osteomilytis in Diabetic Foot patients. The aim of this Study will be to compare the effectiveness and safety of S53P4 bioactive glass, medical device class III used as per its CE mark indication and Instruction For Use, in the surgical management of OM in the forefoot performed as per local surgical standard of care, in the same indications in a group of Diabetic Foot patients admitted in highly specialized dedicated centers. Participants will randomized into two groups: * Patients in Group A will be treated with surgical removal of the affected bone, debridement of infected soft tissues and systemic antibiotic therapy targeted on the sampling on the bone during the surgical procedure, with or without use of bone substitutes (with the only exception of Bioactive glasses) according to the judgement of the operator as per normal practice. * Patients in Group B will be debrided as well and the infected bone will be debrided without eliminating completely the structure of the bone, but instead preserving the cortex, while all the soft bone visibly infected will be removed and then replaced with Bioactive glass, as per IFU, (S53P4 - Bonalive® granules and putty, Bonalive Biomaterials Ltd. Finland) and then closed for primary intention whenever possible.

Official title: A National, Prospective, Randomized, Multicenter, Controlled Comparison of Bioactive Glass S53P4 Versus Standard of Care Treatment of Diabetic Foot Osteomyelitis in the Forefoot

Key Details

Gender

All

Age Range

18 Years - 100 Years

Study Type

INTERVENTIONAL

Enrollment

140

Start Date

2024-03-21

Completion Date

2026-12-30

Last Updated

2024-04-29

Healthy Volunteers

Conditions

Osteomyelitis - Foot

Interventions

DEVICE

Bioactive Glass

Bonalive Granules and Bonalive Putty will be used (according to their IFU and CE certification) to fill the bone void after the debridment of infected tissue as they have osteoconductive and osteostimulative properties that allow bone rigeneration. Moreover, Bonalive Granules also present some bacteria growth inhibiting properties to combact bone infection propoer of Ostemyelitis.

OTHER

Standard of Care

The investigators are left free to proceed according to the normal standar procedure they normally use. The procedures can vary according to investigator judgment also depending on the state of Osteomylitis.

Inclusion Criteria: 1. Written informed consent obtained. 2. Male or female patients \>= of 18 years old. 3. They should have type I since at least 5 years or type II DM 4. They should have a diagnosis - confirmed by imaging and culture - of OM localized in the forefoot not responding for at least 2 up to 6 weeks to systemic antibiotic therapy and/or associated with soft tissue infection, abscess, phlegmon, necrosis, and for which a surgical debridement is indicated. 5. They should have palpable pulses on TP or DP at the ankle in the affected limb, and/or ABPI \>0.7 and \<1.2 and /or TcPO2 at dorsum of the foot ≥36 mmHg. 6. They should be able to accomplish with the procedures and prescriptions indicated by the Study protocol, particularly with the offloading prescription, as well as they should be willing and able to attend and respect the program of control visits and medications. 7. Anatomical area: forefoot. Exclusion Criteria: 1. They should not have metabolic decompensation as witnessed by HbA1c \>109 mmol/mol (\> 12%). 2. They should not have major amputation on the contra-lateral limb. 3. They should not have acute or chronic Charcot's foot in the affected foot. 4. They should not have undergone surgical or endovascular revascularization in the affected foot in the month preceding the enrollment. 5. They should not be taking corticosteroids, bisphosphonates, immunosuppressants, and more in general any drug which might interfere with bone metabolism or tissue repair, in thejudgment of investigators. 6. They should not have ESRD in dialysis. 7. They should not be bedridden or not ambulating. 8. They should not have a life expectancy shorter than one year. 9. They should not be too ill to sustain a surgical procedure under loco-regional anesthesia. 10. They should not have severe disease which might interfere with the expected course of the disease and therapy. 11. Hypersensitivity to any product ingredient(s) or history of anaphylactic reactions. 12. Participation in another interventional studies within 45 days prior to the start of the present study. 13. Predictable poor compliance or inability to communicate well with the investigator.

Locations (7)

ASUGI Azienda Sanitaria Universitaria Giuliano Isontina - Ospedale Monfalcone

Monfalcone, Gorizia, Italy

ASST Ovest Milanese - Ospedale di Abbiategrasso

Abbiategrasso, Milano, Italy

Casa di Cura Abano Terme - POLICLINICO ABANO TERME

Abano Terme, Padova, Italy

USL Sud Est Toscana - Ospedale San Donato

Arezzo, Italy

AUSL Romagna - Ospedale Morgagni Pierantoni

Forlì, Italy

Azienda USL Toscana Nord Ovest - Ospedale Campo di Marte

Lucca, Italy

AOU Pisana - Ospedale di Cisanello

Pisa, Italy