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Trial registered on ANZCTR
Registration number
ACTRN12618000261213
Ethics application status
Approved
Date submitted
1/11/2017
Date registered
20/02/2018
Date last updated
30/11/2018
Date data sharing statement initially provided
30/11/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
The efficacy of topical preparations in reducing the incidence of P. Acnes in total shoulder arthroplasty
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Scientific title
The efficacy of topical preparations in reducing the incidence of P. Acnes in total shoulder arthroplasty
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Secondary ID [1]
293437
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Nil Known
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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:
Total Shoulder Arthroplasty
304930
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Rotator Cuff Injury
305608
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Shoulder Osteoarthritis
305609
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Condition category
Condition code
Surgery
304258
304258
0
0
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Other surgery
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Skin
304573
304573
0
0
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Other skin conditions
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Infection
304829
304829
0
0
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Other infectious diseases
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Musculoskeletal
304830
304830
0
0
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Osteoarthritis
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Injuries and Accidents
304831
304831
0
0
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Other injuries and accidents
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This study aims to investigate the use of BPO and BPO/C as a topical skin preparation and to determine the effects it has in reducing positive superficial and deep cultures in patients undergoing TSA.
3 Groups.
1. Benzoyl Peroxide 5% Gel
2. Phisohex wash (1% triclosan, sodium benzoate 5mg/ml, benzyl alcohol 5mg/ml)
3. Benzoyl Peroxide 5% Gel with Clindamycin Gel 1%
All these are topical skin applications.
Patients are to apply morning and night starting two days prior to surgery and applying their last application the morning of surgery. (Total of 5 applications) The Gel/wash is to be applied liberally to the entire shoulder area as instructed by study investigators and explained with pictures in the patient information consent form document.
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Intervention code [1]
299254
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Treatment: Drugs
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Intervention code [2]
299679
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Treatment: Other
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Intervention code [3]
299680
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Prevention
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Comparator / control treatment
pHisohex (1% triclosan, sodium benzoate 5mg/mL benzyl alcohol 5mg/mL) wash
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Control group
Active
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Outcomes
Primary outcome [1]
303540
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This is a composite primary outcome. To quantify the effects of benzyl peroxide and benzyl peroxide with clindamycin skin prep preoperatively on the ability to reduce superficial colonization and deep tissue inoculation of Propionibacterium. acnes (P. acnes).
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Assessment method [1]
303540
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Timepoint [1]
303540
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Pre-op and intraoperatively swabs will be taken to determine positive P. acnes culture rate.
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Secondary outcome [1]
339242
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To determine the rate of P. Acnes contamination in primary total shoulder arthroplasty.
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Assessment method [1]
339242
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Timepoint [1]
339242
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Following growth of cultures taken intra-operatively - assessed by swabs of shoulder skin area and deep swabs
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Secondary outcome [2]
340178
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To determine the level of compliance relating to application of 3 different shoulder preparations prior to arthroplasty.
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Assessment method [2]
340178
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Timepoint [2]
340178
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Compliance with the various skin preparations will be completed at the 2 week follow-up via survey.
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Secondary outcome [3]
341006
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To determine the rate of P. Acnes innoculation in primary total shoulder arthroplasty.
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Assessment method [3]
341006
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Timepoint [3]
341006
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Following growth of cultures taken intra-operatively - assessed by swabs of shoulder skin area and deep swabs
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Eligibility
Key inclusion criteria
Inclusion criteria:
1. Male or Female
2. Age 30-90
a. This age range depicts the typical population that undergo total shoulder arthroplasty. Participants less than 30 years are not amenable to a total shoulder arthroplasty. Patients older than 90 years often have much higher co-morbidity and have an increased risk of complications and thus do not typically have total shoulder arthroplasty.
4. Patients who require a primary TSA for treatment of OA or rotator cuff injuries
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Minimum age
30
Years
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Maximum age
90
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
Exclusion criteria include:
Patients with active infection
Patients with BMI >40, (may impact on study)
Patients who are pregnant or planning on becoming pregnant during the course of the study
Patients unable to provide informed consent
Patients who have undergone previous arthroplasty, have had previous infection, previous surgical procedures or injection into the shoulder within the previous 6 months prior to surgery.
Patients with documented allergy to any of the skin preparation solutions
Patients with English as second language unless understanding English proficiently or a translator service is available
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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)
Allocation not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer Randomization Number generator program
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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
Phase 4
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Using SPSS version 22
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/03/2018
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Actual
16/07/2018
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Date of last participant enrolment
Anticipated
20/11/2019
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Actual
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Date of last data collection
Anticipated
30/12/2019
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Actual
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Sample size
Target
105
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Accrual to date
17
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
9146
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Mater Hospital Pimlico - Pimlico
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Recruitment postcode(s) [1]
17649
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4810 - Pimlico
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Funding & Sponsors
Funding source category [1]
297646
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Other Collaborative groups
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Name [1]
297646
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Orthopaedic Research Institute Queensland
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Address [1]
297646
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7 Turner Street, Pimlico, 4812. Queensland
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Country [1]
297646
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Australia
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Primary sponsor type
Other Collaborative groups
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Name
Orthopaedic Research Institute Queensland
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Address
7 Turner Street, Pimlico, 4812. Queensland
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Country
Australia
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Secondary sponsor category [1]
296667
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None
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Name [1]
296667
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Address [1]
296667
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Country [1]
296667
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
298732
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Mater Research Governance
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Ethics committee address [1]
298732
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Level 2, Aubigny Place Raymond Terrace South Brisbane QLD 4101
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Ethics committee country [1]
298732
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Australia
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Date submitted for ethics approval [1]
298732
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02/11/2017
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Approval date [1]
298732
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14/11/2017
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Ethics approval number [1]
298732
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Mhs20171114-02
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Summary
Brief summary
Elective total shoulder arthroplasty (TSA) is a common and effective orthopaedic procedure for the treatment of osteoarthritis and rotator cuff injuries. Infection remains a common reason for surgical revision. A common bacteria causing these infection is Propionibacterium Acnes. The current method to reduce post op infections is to use skin preparations prior to surgery. This standard surgical prophylaxis does not seem to decrease the bacterial load. This may be a potential source of infection for susceptible patients having procedures with surgical implants. Benzyl Peroxide (BPO) and Benzyl Peroxide/Clindamycin (BPO/C) topical skin preparations have been shown to reduce the superficial skin colonization of P. acnes. This study aims to investigate the use of BPO and BPO/C as a topical skin preparation and to determine the effects it has in reducing positive cultures in patients undergoing TSA. Study Outcomes • Contamination and inoculation with P. Acnes will be determined via microbiological analysis. Positive cultures will be noted and compared statistically between groups. From this data efficacy between preparations can be determined. • Compliance with the various skin preparations will be completed at the 2 week follow-up via survey.
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
2162
2162
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/AnzctrAttachments/373748-ORIQL Study Protocol TSA - Hinton (1) - with references.docx
(Protocol)
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Attachments [2]
2163
2163
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/AnzctrAttachments/373748-Participant Information Sheet (1.1).docx
(Participant information/consent)
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Contacts
Principal investigator
Name
78050
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Dr Matthew Wilkinson
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Address
78050
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7 Turner St, Pimlico, QLD 4812, Australia.
Orthopedic Research Institute of Queensland
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Country
78050
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Australia
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Phone
78050
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+61 7 4755 0564
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Fax
78050
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Email
78050
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[email protected]
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Contact person for public queries
Name
78051
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Andrea Grant
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Address
78051
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7 Turner St, Pimlico, QLD 4812, Australia.
Orthopedic Research Institute of Queensland
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Country
78051
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Australia
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Phone
78051
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+61 7 4755 0564
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Fax
78051
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Email
78051
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[email protected]
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Contact person for scientific queries
Name
78052
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Andrea Grant
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Address
78052
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7 Turner St, Pimlico, QLD 4812, Australia.
Orthopedic Research Institute of Queensland
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Country
78052
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Australia
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Phone
78052
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+61 7 4755 0564
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Fax
78052
0
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Email
78052
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Undecided
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No/undecided IPD sharing reason/comment
At this current point in time I would need to discuss with the investigative team if sharing this data would be appropriate.
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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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