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Trial registered on ANZCTR
Registration number
ACTRN12616000343404p
Ethics application status
Submitted, not yet approved
Date submitted
1/03/2016
Date registered
16/03/2016
Date last updated
16/03/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
Can early intervention with CO2 laser therapy promote scar maturation following a burn injury?
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Scientific title
Can early intervention with CO2 laser therapy promote scar maturation following a burn injury?
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Secondary ID [1]
288669
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Nil
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Universal Trial Number (UTN)
U1111-1180-2398
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Trial acronym
N/A
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Burn injury
297862
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Scar
297863
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Condition category
Condition code
Skin
298036
298036
0
0
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Other skin conditions
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Injuries and Accidents
298037
298037
0
0
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Burns
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A 10,600nm fractional carbon dioxide laser supplied by Lumenis Ltd is the device to be used in this study. This laser has FDA approval for over 100 applications including the management of scars. It has the ability to deliver precise high energy in short-pulses to thickened scars, and has a good record for safety and outcomes. Participants will receive 3 laser treatments 4- 6 weeks apart. The timing of procedures is dependent on patient availability and availability of surgical capacity (ie space on theatre list). Each treatment session lasts between 5 and 15 minutes, depending on the size treated. The patient will receive either a general or local anesthetic prior to the procedure. The choice of anesthetic is at the patient's discretion. The treatments are delivered in a laser safe environment - either in the operating theatre or the laser treatment room on the burns unit. The area to be treated is determined by the surgeon and the patient before the procedure. The laser treatment is delivered by the burn surgeon who is trained in the use of laser therapies and holds a current laser licence. Outcome measures will be conducted before laser treatment, after the third (last) treatment of laser and 3 months after the third laser treatment.
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Intervention code [1]
294086
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Treatment: Devices
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Intervention code [2]
294142
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Treatment: Surgery
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Comparator / control treatment
Patients with 2 or more non-contiguous discrete burn areas will be recruited into this study. Each patient will act as their own control. Scar sites will be numbered and each site will be allocated to either LASER (L) or CONTROL (C) treatment regimes. A minimum of two sites are required in each patient. For patients with more than two eligible sites, the most closely matched pair in appearance (based on Vancouver Scar Scale) will be selected. These two scars will then be randomly allocated as the LASER (L) or CONTROL (C) scar. The participant will be unaware of the treated site
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Control group
Active
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Outcomes
Primary outcome [1]
297551
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To determine the effect of CO2 laser treatment on the clinical outcome of burn scars versus standard scar therapy. This will be assess using scar assessment measures: Vancouver Scar Scale( VSS) and Patient and Observer Scar Assessment Scale (POSAS)
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Assessment method [1]
297551
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Timepoint [1]
297551
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3 months post 3rd laser treatment
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Secondary outcome [1]
321395
0
Time in pressure garments assessed by medical records.
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Assessment method [1]
321395
0
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Timepoint [1]
321395
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3 months post 3rd laser treatment
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Secondary outcome [2]
321587
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Need for reconstructive surgery assessed by medical records.
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Assessment method [2]
321587
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Timepoint [2]
321587
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3 months post 3rd laser treatment.
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Eligibility
Key inclusion criteria
Adults > 18 years of age
Two or more non-contiguous discrete burn areas
Each burn > 1% TBSA
Scars which would ordinarily be managed by pressure garments
All patients to be at least 3 months from burn injury
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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
Pregnant or lactating females,
Facial scars
Keloid scars
Inability to give informed consent
Systemic glucocorticoid use
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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)
Each patient will act as their own control. Scar sites will be numbered and each site will be allocated to either LASER (L) or CONTROL (C) treatment regimes. A minimum of two sites are required in each patient. For patients with more than two eligible sites, the most closely matched pair in appearance (based on Vancouver Scar Scale) will be selected. These two scars will then be randomly allocated as the LASER (L) or CONTROL (C) scar.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using coin-tossing
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
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Intervention assignment
Single group
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Descriptive, univariate statistics will be used to describe the general characteristics of the sample. Each patient serves as their own control, and no assumptions will be made regarding the distribution of the data. Hence, differences between “Control” and “Intervention” areas will be examined using the Wilcoxon Signed Rank test, and a p value < 0.05 will be considered to indicate statistical significance. All statistical analysis will be conducted using the statistical package for social sciences (SPSS) program (version 17.0) and STATA. There is no information in the literature on which to base an accurate or meaningful sample size calculation. We are proposing the conventional sample size of 20 patients for a pilot study. This will provide sufficient information to enable an accurate sample size correction for use in a larger trial should a benefit be observed. If no benefit is seen to occur, then we can calculate the probability of having missed a potential benefit in our trial. This data will therefore inform the decision as to whether a future larger trial is warranted, or whether it would be a futile endeavour
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
4/04/2016
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Actual
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Date of last participant enrolment
Anticipated
3/04/2017
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
20
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
5376
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Fiona Stanley Hospital - Murdoch
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Recruitment postcode(s) [1]
12829
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6150 - Murdoch
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Funding & Sponsors
Funding source category [1]
293030
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Government body
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Name [1]
293030
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WA Health Department SHRAC Grant
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Address [1]
293030
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189 Royal St, East Perth WA 6004
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Country [1]
293030
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Australia
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Primary sponsor type
Individual
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Name
Prof Suzanne Rea
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Address
State Adult Burns Unit
Level 4
Fiona Stanley Hospital
102-118 Murdoch Drive
Murdoch, Perth, WA
6150
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Country
Australia
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Secondary sponsor category [1]
291805
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Charities/Societies/Foundations
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Name [1]
291805
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Fiona Wood Foundation
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Address [1]
291805
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State Adult Burns Unit
Level 4,
Fiona Stanley Hospital,
102-118 Murdoch Drive
Murdoch, WA,
6150
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Country [1]
291805
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Australia
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
294541
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South Metropolitan Health Service Human Research Ethics Committee
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Ethics committee address [1]
294541
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Level 2, Southern Research Facility (Perkins Building) Fiona Stanley Hospital,11 Robin Warren Drive, MURDOCH WA 6150, Western Australia
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Ethics committee country [1]
294541
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Australia
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Date submitted for ethics approval [1]
294541
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26/11/2016
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Approval date [1]
294541
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Ethics approval number [1]
294541
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Summary
Brief summary
In high income countries, improvements in first aid and acute specialised care have resulted in reduced mortality from major burn injuries (from approximately 25% to less than 9%). Although specialised care has significantly improved outcomes for these patients, the near universal complication of burn-related scarring persists as a constant reminder of limitations of care. For burn survivors, the development of painful, restrictive and disfiguring scarring, known as hypertrophic scarring (HS), has an incidence ranging from 30-70% in reviewed epidemiological data. The treatment of scarring has, thus far, been unable to keep pace with the advancements in resuscitation and other acute therapies. The consequences of scar formation are many and varied, including joint contractures and stiffness, chronic pain, itching, and anhydrosis. Additionally, the emotional repercussions can be significant, with many patients reporting stigmatization and discrimination due to their burn scars. As the mortality of acute burn injury continues to diminish, the burden of scarring may continue to rise. Current treatment options for hypertrophic scarring are not yet sufficient to significantly reduce its associated morbidity. Burn clinicians and researchers are focused on understanding scarring in more depth and discovering potential ways to improve patient outcomes. Within this field of innovation, laser resurfacing techniques are gaining greater interest and are currently being utilised in several centres worldwide for the treatment of HS. The aim of this study is to investigate if the early use of laser treatment helps minimise scar, decreases the time required in pressure garments, improves range of motion and thus results in fewer episodes of expensive reconstructive surgery. A 10,600nm fractional carbon dioxide laser supplied by Lumenis Ltd is the device to be used in this study. This laser has FDA approval for over 100 applications including the management of scars. It has the ability to deliver precise high energy in short-pulses to thickened scars, and has a good record for safety and outcomes. The Burns Service of WA has been using this laser for over 18 months for the management of scars, and the health professionals involved have received the appropriate safety training. Participants will receive 3 laser treatments 4-6 weeks apart. Outcome measures will be conducted before laser treatment, after the last treatment of laser and 3 months post laser treatment.
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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
64054
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Prof Suzanne Rea
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Address
64054
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State Adult Burns Unit
Level 4
Fiona Stanley Hospital
102 -118 Murdoch Drive
Murdoch, Perth, WA
6150
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Country
64054
0
Australia
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Phone
64054
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+61 413 827 186
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Fax
64054
0
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Email
64054
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[email protected]
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Contact person for public queries
Name
64055
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Suzanne Rea
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Address
64055
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State Adult Burns Unit
Level 4
Fiona Stanley Hospital
102 -118 Murdoch Drive
Murdoch, Perth, WA
6150
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Country
64055
0
Australia
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Phone
64055
0
+61 413 827 186
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Fax
64055
0
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Email
64055
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[email protected]
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Contact person for scientific queries
Name
64056
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Suzanne Rea
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Address
64056
0
State Adult Burns Unit
Level 4
Fiona Stanley Hospital
102 - 118 Murdoch Drive
Murdoch, Perth, WA
6150
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Country
64056
0
Australia
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Phone
64056
0
+61 413 827 186
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Fax
64056
0
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Email
64056
0
[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
Carbon dioxide laser treatment of burn-related scarring: Results of the ELIPSE (Early Laser Intervention Promotes Scar Evolution) prospective randomized controlled trial.
2023
https://dx.doi.org/10.1016/j.bjps.2023.06.012
N.B. These documents automatically identified may not have been verified by the study sponsor.
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