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Trial registered on ANZCTR
Registration number
ACTRN12609001023246
Ethics application status
Approved
Date submitted
23/11/2009
Date registered
25/11/2009
Date last updated
8/12/2015
Type of registration
Prospectively registered
Titles & IDs
Public title
A prospective randomized control trial comparing a non adherent dry dressing with a silver foam dressing in the management of Kirscher wire (K-wire) pin sites in the closed fractures of the hand.
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Scientific title
A prospective randomized control trial comparing a non adherent dry dressing with a silver foam dressing in the management of Kirscher wire (K-wire) pin sites in the closed fractures of the hand.
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Secondary ID [1]
1145
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
The incidence of infection after K-wire insertion using a dry non-adherent and a wet wound dressing
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The ease of application and removal between the two dressings
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Comparison of the ease of application and removal between the two dressings
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Comparison of pain assoicated with the application and removal of the two dressings
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Condition category
Condition code
Injuries and Accidents
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0
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Fractures
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The K-wire is inserted as per normal surgical practice. The wound is dressed using the dry dressing. As per standard clinical practice - the patient attends outpatients weekly for up to 8 weeks The dressing is assessed at each appointment as to whether it needs changing. .K-wire removal usually occurring after 4 weeks.
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Intervention code [1]
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Treatment: Other
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Comparator / control treatment
The K-wire is inserted as per normal surgical practice. The wound is dressed with the silver foam dressing which is a wet dressing (compared to the dry control dressing). As per standard clinical practice - the patient attends outpatients weekly for up to 8 weeks. The dressing is assessed at each appointment to assess whether it needs changing. K-wire removal usually occurring after 4 weeks.
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Control group
Active
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Outcomes
Primary outcome [1]
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The wound will be photographed at each weekly outpatient appointment and assessed on a pin infection rate scale (Sims and Saleh 1996). Temperature, Full blood examination (FBE), erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), X-ray will be done if the infection is graded at 3 or above.
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Assessment method [1]
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Timepoint [1]
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Weekly until removal of K-wire (usually up to 8 weeks)
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Secondary outcome [1]
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Ease of removal and application at each dressing change will be assessed using a 5 point scale (very easy through to very difficult)
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Assessment method [1]
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Timepoint [1]
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At each dressing change
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Secondary outcome [2]
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Pain on removal of dressing will be assessed using a visual analog pain scale ( 0 - 10)
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Assessment method [2]
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Timepoint [2]
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At each dressing change
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Secondary outcome [3]
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Need for cleanining of pin site will be assessed using Yes (pin site needs cleaning) or No (pin site is clean)
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Assessment method [3]
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Timepoint [3]
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At each dressing change
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Eligibility
Key inclusion criteria
Closed fractures of the hand distal to the wrist crease
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Minimum age
1
Years
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Maximum age
100
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Open fractures
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
All subjects fitting the inclusion criteria will be invited to participate in the study. Allocation to a treatment group will be done by sealed envelopes.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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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
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/01/2010
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
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Actual
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Sample size
Target
120
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Peninsula health
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Address [1]
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PO Box 52
Frankston VIC 3199
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Country [1]
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Australia
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Funding source category [2]
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Commercial sector/Industry
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Name [2]
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Smith and Nephew
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Address [2]
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P O Box 242
Mount Waverley VIC 3149
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Country [2]
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Australia
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Primary sponsor type
Hospital
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Name
Peninsula health
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Address
PO Box 52
Frankston VIC 3199
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Peninsula Health
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Ethics committee address [1]
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PO Box 52 Frankston VIC 3199
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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26/10/2009
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Approval date [1]
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09/11/2009
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Ethics approval number [1]
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2009-66
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Summary
Brief summary
This study looks at two types of surgical wound dressing used after fixing fractures of the hand with a pin called a K-wire and whether there is a difference in infection rates and the ease of , and pain associated with, application and removal. When a person fractures a bone they may have a closed fracture or an open or compound fracture. A closed fracture is when the broken bone does not penetrate the skin. In this study, we are only looking at patients with closed fractures. In addition, for inclusion in this study, the fracture must be of the hand higher (distal) than the wrist crease. The Kirscher Wire Pin (commonly known as a K-wire) is a sharpened, sterilised metal pin that is used to hold the fractured bone fragments together. After insertion of the K-wire, the wound is dressed and then assessed on a weekly basis for infection. Infection is common (about 10% of cases) because the insertion of the wire through the skin into the bone creates a passage for bacteria. The area around the wire may become red and swollen and there may be a discharge. Antibiotics may have to be prescribed and sometimes the pin needs to be removed prematurely. Current practice involves dressing the wound in Melolin – a dry non-adherent sterile dressing and Mefix – a surgical tape. In this study we would like to compare this dressing with a new anti-microbial barrier dressing which contain nanocrystalline silver. This type of silver has long been known for its antimicrobial properties. The patients would be consented prior to surgery and then randomly allocated one of the two wound dressings. For both arms of the study, the patients will be followed up and assessed in exactly the same manner. If a patient does not wish to participate in the trial the wound will be dressed in the dry dressing as is current practice.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Patricia Terrill
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Address
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Frankston Hospital, department of surgery
PObox52
Frankston Vic3199
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Country
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Australia
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Phone
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613 9784 8416
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Fax
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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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Dr Patricia Terill
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Address
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Frankston Hospital
PO Box 52
Frankston VIC 3199
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Country
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Australia
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Phone
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+61 3 9784 7777
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Fax
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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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Dr Patricia Terill
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Address
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Frankston Hospital
PO Box 52
Frankston VIC 3199
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Country
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Australia
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Phone
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+61 3 9784 7777
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Fax
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Email
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[email protected]
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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.
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