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Trial registered on ANZCTR
Registration number
ACTRN12609001080213
Ethics application status
Approved
Date submitted
15/12/2009
Date registered
16/12/2009
Date last updated
17/04/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
A randomised controlled trial of Eutectic Mixture of Lidocaine and Prilocaine (EMLA) cream as a primary dressing for painful chronic leg ulcers: A pilot study.
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Scientific title
A randomised controlled trial of Eutectic Mixture of Lidocaine and Prilocaine (EMLA) cream as a primary dressing for the reduction in wound related pain associated with chronic leg ulcers: A pilot study.
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Secondary ID [1]
1203
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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:
Reduction of pain in lower leg ulcers.
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Condition category
Condition code
Anaesthesiology
256581
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Pain management
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The participants will be randomized to receive EMLA 5% to their painful chronic lower leg ulcers daily as a primary dressing daily for a total of 4 weeks. The dose is 1gm per 10 sq cms. This topical cream will be applied to the wound bed by the participating community clinic nurses
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
Control group will receive receive dressings deemed appropriate by the nurse at each required clinic visit. Visits to the clinic by the control group will be determined by the clinical presentation of the wound. Visits could be daily up to weekly. The dressing choices will reflect usual care options and will include primary dressings such as: alginate, hydrofibre, hydrogel, enzyme alginogel, povidone iodine mesh, cadexamer iodine, silver impregnated dressings.
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Control group
Active
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Outcomes
Primary outcome [1]
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Wound-related pain (WRP) intensity and quality.
WRP intensity was measured using the Numerical Rating Scale.
WRP quality was measured from data collected using the Wound-related pain at dressing assessment tool - Question 5 on the tool.
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Assessment method [1]
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Timepoint [1]
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Measured at baseline and at every dressing change for 12 weeks.
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Secondary outcome [1]
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Health-related quality of life using the validated Cardiff Wound Impact Schedule.
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Assessment method [1]
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Timepoint [1]
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Measured at baseline and weeks 4 and 12.
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Secondary outcome [2]
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Another secondary clinical outcome was wound healing. Wound surface areas were measured.
Wound measurement was conducted by a specialist nurse in wound care not blinded to subjects group allocation.
To detect changes in wound appearance the validated Leg Ulcer Measurement Tool was used.
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Assessment method [2]
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Timepoint [2]
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Measured at baseline and weeks 4 and 12.
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Eligibility
Key inclusion criteria
Patient has one or more chronic lower leg ulcer(s) of at least 6 weeks duration and up to 100cm2 in size in total.
Patients with low to moderate wound exudate.
Numerical Rating Scale pain score = 4 at assessment and/or within the previous week.
Patients currently requiring oral analgesics due to previously reported wound-related pain.
Patients have the capacity to consent to participation.
Patients have the capacity to attend the Community Nursing Procedure clinics.
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Minimum age
18
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?
No
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Key exclusion criteria
Patients scheduled for leg amputation.
History of peripheral sensory neuropathy of the feet.
Patients that have had or require the use of EMLA cream for debridement of the wound bed within the previous 4 weeks.
Patients with suspected wound malignancy or pyoderma gangrenosum, confirmed by biopsy.
Patients with diagnosed localized or spreading clinical wound infection.
End stage palliative care patients.
Allergy to EMLA cream and/or history of local anesthetic drug sensitivity
A history of congenital or idiopathic methemoglobinemia
Patients on Class III anti-arrhythmic drugs.
Severe hepatic disease.
Pregnant and/or lactating women.
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Study design
Purpose of the study
Prevention
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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)
PASS 2008 Power Analysis and Sample Size software (NCSS, Kaysville, Utah) was used to generate the allocation sequence by a researcher not involved with screening patients; the investigator was blinded to the allocations.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer generated random numbers
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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
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Statistical methods / analysis
Data were entered and checked for missing and invalid values in Microsoft Excel® then imported into Statistical Analysis for Social Scientists (SPSS Version 22, Chicago, USA) for analysis. A random sample (10%) of the data was verified against the original case report form. Quantitative data were analysed using descriptive statistics. Qualitative data from field notes were analysed using descriptive content analysis.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
31/01/2010
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Actual
16/09/2010
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Date of last participant enrolment
Anticipated
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Actual
20/03/2013
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Date of last data collection
Anticipated
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Actual
12/06/2013
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Sample size
Target
60
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Accrual to date
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Final
60
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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NSW Department of Health Nursing & Midwifery Office
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Address [1]
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73 Miller St North Sydney NSW 2060.
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Country [1]
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Australia
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Funding source category [2]
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Government body
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Name [2]
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Central Coast Local Health District Central Coast Health Research Advisory Committee
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Address [2]
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Gosford Hospital
PO Box 361 Gosford. NSW 2250
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Country [2]
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Australia
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Funding source category [3]
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Charities/Societies/Foundations
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Name [3]
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Australian Wound Management Association Research Foundation
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Address [3]
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Division of Nursing and Midwifery Faculty of Health Sciences
La Trobe University
Bundoora VIC 3083
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Country [3]
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Australia
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Primary sponsor type
Hospital
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Name
Central Coast Local Health District
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Address
Central Coast Community Nursing Service
Wyong Community Health Centre
38A Pacific Hwy
Wyong NSW 2259
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Country
Australia
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Central Coast Local Health District Division of Aged, Subacute & Complex Care
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Address [1]
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Gosford Hospital
PO Box 361
Gosford. NSW 2250
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Harbour HREC
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Ethics committee address [1]
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Research Business Unit Level 2, Building 51 Royal North Shore Hospital Pacific Hwy St Leonards NSW 2065
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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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16/11/2009
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Approval date [1]
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10/06/2010
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Ethics approval number [1]
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Protocol 0911-318M(CTN)
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Summary
Brief summary
The aims of this study will address the following hypotheses, that: The daily topical application of EMLA cream to the wound bed reduces pain levels for patients with a chronic leg ulcer. Improvement in pain levels will be associated with reduced need for oral analgesia, particularly opiates. Topical application of EMLA cream to the wound bed decreases healing time for chronic leg ulcers Improvement in leg ulcer pain and/or wound healing will be associated with gains in health-related quality of life. Hypothesis Our hypothesis is that the daily topical application of EMLA 5% cream to the wound bed of painful chronic leg ulcers as the primary dressing, will reduce wound-related pain and analgesic requirements, and improve the quality of life for patients with painful chronic leg ulcers. The secondary outcome measure is decreased wound healing times. As the primary outcome measure is pain reduction, this study will investigate painful chronic leg ulcers of varying aetiology, including venous, arterial and/or mixed ulceration.
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Trial website
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Trial related presentations / publications
Purcell A, Buckley T, Fethney J, King J, Moyle W, Marshall AP. The effectiveness of EMLA® as a primary dressing on painful chronic leg ulcers - a pilot randomised controlled trial. Adv Skin Wound Care. 2017;30(8):354-363. Purcell A, Buckley T, Fethney J, King J, Moyle W, Marshall AP. The effectiveness of EMLA® as a primary dressing on painful chronic leg ulcers: effects on wound healing and health-related quality of life. Int J Low Extrem Wounds. 2017;16(3):163-172.
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Public notes
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Contacts
Principal investigator
Name
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Ms Anne Purcell
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Address
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Central Coast Local Health District
Community Nursing Service
38A Pacific Hwy
Wyong NSW 2259
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Country
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Australia
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Phone
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+61414192868
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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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Anne Purcell
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Address
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Central Coast Community Nursing Service
Wyong Community Health Center
38A Pacific Hwy
Wyong NSW 2259
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Country
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Australia
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Phone
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+61 414192868
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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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Anne Purcell
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Address
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Central Coast Community Nursing Service
Wyong Community Health Center
38A Pacific Hwy
Wyong NSW 2259
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Country
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Australia
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Phone
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+61 414192868
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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
Source
Title
Year of Publication
DOI
Embase
Eutectic mixture of local anaesthetics (EMLA) as a primary dressing on painful chronic leg ulcers: A pilot randomised controlled trial.
2018
https://dx.doi.org/10.1186/s40814-018-0312-6
N.B. These documents automatically identified may not have been verified by the study sponsor.
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