Diabetic UlcerNCT03046628
Evaluation of Lower Extremity Tissue Perfusion With Polarized Laser Light
A study testing TcPO2 and Green laser (at 532nm) and a fast camera in people with Diabetic Ulcer and Perfusion, run by Meir Medical Center.
Trial summary
The aim of this study is to test the feasibility of using polarised green laser and CMOS camera in order to assess the tissue perfusion of lower extremity ulcers in patients suffering from diabetic foot by comparing this method with the percutaneous tissue oxygen tension examination which is currently the "gold… Read more about this study
- Who is it for?
- Ages 18 to 85 years
- Conditions the study is for
- Diabetic Ulcer, Perfusion
- What is being tested?
- TcPO2 and Green laser (at 532nm) and a fast camera
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 30 participants
- Where
- No sites listed yet
- Study dates
- Feb 2017to Jun 2018
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 85 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients suffering from chronic diabetic ulcers
Who cannot join
- Patients after amputation of some part in the lower limb
- Patients with acute infection on bony involvement
Trial locations and contacts
No sites are listed yet.
About this study
Official title: A Feasibility Study of Using Technology Based on Polarized Laser Light and Speed Camera for Non-invasive Tissue Perfusion Assessment of the Lower Extremities
The aim of this study is to test the feasibility of using polarised green laser and CMOS camera in order to assess the tissue perfusion of lower extremity ulcers in patients suffering from diabetic foot by comparing this method with the percutaneous tissue oxygen tension examination which is currently the "gold standard" examination.
Read the detailed description
An objective assessment of blood supply and oxygen delivery to the damaged tissue in patients with diabetic ulcer is very problematic with various currently accepted auxiliary examinations. These tests include measuring blood pressure ratio between the ankle or toes arm (ABI \ TBI), Sonar Doppler examination of the lower limb arteries, and percutaneous tissue oxygen tension examination (TcPO2). Each of these tests, along with the obvious advantages esprit ability to assess a non-invasive blood as number of disadvantages.
As the blood supply to the tissue is the most important healing of the tissue regardless of the type of intervention chosen (conservative treatment includes systemic antibiotics or surgical debridement), there is clear necessity for a non-invasive test with high reliably assessing tissue perfusion in patients with diabetic ulcers.
Recently, a new a method for assessing multiple features in vital tissues using polarised laser light was introduced. The technique is based on tracking temporal changes of reflected secondary speckles produced in the skin when being illuminated by a laser beam. Change in skin's temporal vibration profile is generated by time varied oxygen concentration caused these temporal changes. This technology of nanometer motion sensing allows, according to studies already carried out, monitoring parameters such as blood pressure, pulse rate and heart rhythm, glucose concentration in the blood substances and alcohol, oxygen saturation and intraocular pressure.
In this study the investigators will examine, non-invasively, the tissue around the lower limb ulcers of 30 diabetic patients, beginning with the TcPO2 examination followed by the polarised laser light and complementary metal-oxide semiconductor (CMOS) camera examination, and analysing the data in order to determine the ability of the latter method for assessing the tissue oxygen pressure.
- Conditions
- Diabetic Ulcer, Perfusion
- Being tested
- TcPO2, Green laser (at 532nm) and a fast camera
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
TcPO2Device
Also called TCM400, Radiometer, Denmark
Green laser (at 532nm) and a fast cameraDevice
Also called PixelLink PL-E531, continuous green laser
| Study group | Role | What they receive |
|---|---|---|
| Patients with diabetic feet ulcers | Experimental | Each patient will be examined twice, first with TcPO2 (TCM400, Radiometer Medical ApS, Denmark) and then with a green laser (harmonic of continuous neodymium-doped yttrium aluminium garnet laser 532-nm wavelength and fast camera (PixelLink PLE531) system. Receives: Device: TcPO2; Device: Green laser (at 532nm) and a fast camera |
What is being measured
The primary outcome is the main question the study is designed to answer.
Correlation between TcPO2 results and reflected secondary speckle patterns
recording and comparing between the examinations of each diabetic ulcer
Measured: through study completion, an average of 1 year
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Feb 2017 (estimated)
- Study startFeb 2017
- Primary completionJan 2018 (estimated)
- Study completionJun 2018 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (13)Papers the sponsor has linked to this study.
- Other trials for Diabetic UlcerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Diagnosis
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 30 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Meir Medical Center
- Sponsor type
- University, hospital or other
- Collaborators
- Bar-Ilan University, Israel
- Responsible party
- Sponsor
- Investigators
- Meir Nyska, Prof., Study director, Head of the orthopaedic department
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03046628
- Sponsor's protocol ID
- MMC1602-16CTIL
- Status last verified
- Jan 2017
- First submitted
- 10 Jan 2017
- Last updated
- 8 Feb 2017
- Results posted
- No
Publications
LoGerfo FW, Coffman JD. Current concepts. Vascular and microvascular disease of the foot in diabetes. Implications for foot care. N Engl J Med. 1984 Dec 20;311(25):1615-9. doi: 10.1056/NEJM198412203112506. No abstract available.
PubMed 6390204Consensus development conference on diabetic foot wound care. 7-8 April 1999, Boston, MA. American Diabetes Association. Adv Wound Care. 1999 Sep;12(7):353-61. No abstract available.
PubMed 10687555Rayman G, Williams SA, Spencer PD, Smaje LH, Wise PH, Tooke JE. Impaired microvascular hyperaemic response to minor skin trauma in type I diabetes. Br Med J (Clin Res Ed). 1986 May 17;292(6531):1295-8. doi: 10.1136/bmj.292.6531.1295.
PubMed 2939920Schaper NC, Andros G, Apelqvist J, Bakker K, Lammer J, Lepantalo M, Mills JL, Reekers J, Shearman CP, Zierler RE, Hinchliffe RJ. Diagnosis and treatment of peripheral arterial disease in diabetic patients with a foot ulcer. A progress report of the International Working Group on the Diabetic Foot. Diabetes Metab Res Rev. 2012 Feb;28 Suppl 1:218-24. doi: 10.1002/dmrr.2255.
PubMed 22271741Alexandrescu VA, Hubermont G, Philips Y, Guillaumie B, Ngongang C, Vandenbossche P, Azdad K, Ledent G, Horion J. Selective primary angioplasty following an angiosome model of reperfusion in the treatment of Wagner 1-4 diabetic foot lesions: practice in a multidisciplinary diabetic limb service. J Endovasc Ther. 2008 Oct;15(5):580-93. doi: 10.1583/08-2460.1.
PubMed 18840046Lukkari-Rautiarinen E, Lepantalo M, Pietila J. Reproducibility of skin blood flow, perfusion pressure and oxygen tension measurements in advanced lower limb ischaemia. Eur J Vasc Surg. 1989 Aug;3(4):345-50. doi: 10.1016/s0950-821x(89)80072-6.
PubMed 2670609Beiderman Y, Amsel AD, Tzadka Y, Fixler D, Mico V, Garcia J, Teicher M, Zalevsky Z. A microscope configuration for nanometer 3-D movement monitoring accuracy. Micron. 2011 Jun;42(4):366-75. doi: 10.1016/j.micron.2010.05.020. Epub 2010 Sep 19.
PubMed 20888247Zalevsky Z, Beiderman Y, Margalit I, Gingold S, Teicher M, Mico V, Garcia J. Simultaneous remote extraction of multiple speech sources and heart beats from secondary speckles pattern. Opt Express. 2009 Nov 23;17(24):21566-80. doi: 10.1364/OE.17.021566.
PubMed 19997398Beiderman Y, Horovitz I, Burshtein N, Teicher M, Garcia J, Mico V, Zalevsky Z. Remote estimation of blood pulse pressure via temporal tracking of reflected secondary speckles pattern. J Biomed Opt. 2010 Nov-Dec;15(6):061707. doi: 10.1117/1.3505008.
PubMed 21198155Beiderman Y, Blumenberg R, Rabani N, Teicher M, Garcia J, Mico V, Zalevsky Z. Demonstration of remote optical measurement configuration that correlates to glucose concentration in blood. Biomed Opt Express. 2011 Mar 14;2(4):858-70. doi: 10.1364/BOE.2.000858.
PubMed 21483609Ozana N, Arbel N, Beiderman Y, Mico V, Sanz M, Garcia J, Anand A, Javidi B, Epstein Y, Zalevsky Z. Improved noncontact optical sensor for detection of glucose concentration and indication of dehydration level. Biomed Opt Express. 2014 May 22;5(6):1926-40. doi: 10.1364/BOE.5.001926. eCollection 2014 Jun 1.
PubMed 24940550Margalit I, Beiderman Y, Skaat A, Rosenfeld E, Belkin M, Tornow RP, Mico V, Garcia J, Zalevsky Z. New method for remote and repeatable monitoring of intraocular pressure variations. J Biomed Opt. 2014 Feb;19(2):027002. doi: 10.1117/1.JBO.19.2.027002.
PubMed 24503638Golberg M, Fixler D, Shainberg A, Zlochiver S, Mico V, Garcia J, Beiderman Y, Zalevsky Z. Speckle-based configuration for simultaneous in vitro inspection of mechanical contractions of cardiac myocyte cells. J Biomed Opt. 2013 Oct;18(10):101310. doi: 10.1117/1.JBO.18.10.101310.
PubMed 23856787
Study at a glance
From the registry record, last updated by the sponsor on 8 Feb 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Feasibility Study of Using Technology Based on Polarized Laser Light and Speed Camera for Non-invasive Tissue Perfusion Assessment of the Lower Extremities
- ClinicalTrials.gov ID
- NCT03046628
- Acronym / sponsor ID
- MMC1602-16CTIL
- Conditions
- Diabetic Ulcer, Perfusion
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 30 participants (estimated)
- Lead sponsor
- Meir Medical CenterUniversity, hospital or other
- Collaborators
- Bar-Ilan University, Israel
- Study start
- Feb 2017
- Primary completion
- Jan 2018 (estimated)
- Study completion
- Jun 2018 (estimated)
- First posted
- 8 Feb 2017 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of this study is to test the feasibility of using polarised green laser and CMOS camera in order to assess the tissue perfusion of lower extremity ulcers in patients suffering from diabetic foot by comparing this method with the percutaneous tissue oxygen tension examination which is currently the "gold standard" examination.
Detailed description
An objective assessment of blood supply and oxygen delivery to the damaged tissue in patients with diabetic ulcer is very problematic with various currently accepted auxiliary examinations. These tests include measuring blood pressure ratio between the ankle or toes arm (ABI \ TBI), Sonar Doppler examination of the lower limb arteries, and percutaneous tissue oxygen tension examination (TcPO2). Each of these tests, along with the obvious advantages esprit ability to assess a non-invasive blood as number of disadvantages.
As the blood supply to the tissue is the most important healing of the tissue regardless of the type of intervention chosen (conservative treatment includes systemic antibiotics or surgical debridement), there is clear necessity for a non-invasive test with high reliably assessing tissue perfusion in patients with diabetic ulcers.
Recently, a new a method for assessing multiple features in vital tissues using polarised laser light was introduced. The technique is based on tracking temporal changes of reflected secondary speckles produced in the skin when being illuminated by a laser beam. Change in skin's temporal vibration profile is generated by time varied oxygen concentration caused these temporal changes. This technology of nanometer motion sensing allows, according to studies already carried out, monitoring parameters such as blood pressure, pulse rate and heart rhythm, glucose concentration in the blood substances and alcohol, oxygen saturation and intraocular pressure.
In this study the investigators will examine, non-invasively, the tissue around the lower limb ulcers of 30 diabetic patients, beginning with the TcPO2 examination followed by the polarised laser light and complementary metal-oxide semiconductor (CMOS) camera examination, and analysing the data in order to determine the ability of the latter method for assessing the tissue oxygen pressure.
Study design
- Primary purpose
- Diagnosis
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Patients with diabetic feet ulcers | Experimental | Device: TcPO2, Device: Green laser (at 532nm) and a fast cameraEach patient will be examined twice, first with TcPO2 (TCM400, Radiometer Medical ApS, Denmark) and then with a green laser (harmonic of continuous neodymium-doped yttrium aluminium garnet laser 532-nm wavelength and fast camera (PixelLink PLE531) system. |
Who may qualify
- Ages
- 18 to 85 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- Patients suffering from chronic diabetic ulcers
Key exclusion criteria (2 listed)
- Patients after amputation of some part in the lower limb
- Patients with acute infection on bony involvement
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| TcPO2Also: TCM400, Radiometer, Denmark | Device | Patients with diabetic feet ulcers |
| Green laser (at 532nm) and a fast cameraAlso: PixelLink PL-E531, continuous green laser | Device | Patients with diabetic feet ulcers |
Primary outcome
Correlation between TcPO2 results and reflected secondary speckle patterns
Time frame: through study completion, an average of 1 year
recording and comparing between the examinations of each diabetic ulcer
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Feb 2017.
- Background: PubMed 6390204LoGerfo FW, Coffman JD. Current concepts. Vascular and microvascular disease of the foot in diabetes. Implications for foot care. N Engl J Med. 1984 Dec 20;311(25):1615-9. doi: 10.1056/NEJM198412203112506. No abstract available.
- Background: PubMed 10687555Consensus development conference on diabetic foot wound care. 7-8 April 1999, Boston, MA. American Diabetes Association. Adv Wound Care. 1999 Sep;12(7):353-61. No abstract available.
- Background: PubMed 2939920Rayman G, Williams SA, Spencer PD, Smaje LH, Wise PH, Tooke JE. Impaired microvascular hyperaemic response to minor skin trauma in type I diabetes. Br Med J (Clin Res Ed). 1986 May 17;292(6531):1295-8. doi: 10.1136/bmj.292.6531.1295.
- Background: PubMed 22271741Schaper NC, Andros G, Apelqvist J, Bakker K, Lammer J, Lepantalo M, Mills JL, Reekers J, Shearman CP, Zierler RE, Hinchliffe RJ. Diagnosis and treatment of peripheral arterial disease in diabetic patients with a foot ulcer. A progress report of the International Working Group on the Diabetic Foot. Diabetes Metab Res Rev. 2012 Feb;28 Suppl 1:218-24. doi: 10.1002/dmrr.2255.
- Background: PubMed 18840046Alexandrescu VA, Hubermont G, Philips Y, Guillaumie B, Ngongang C, Vandenbossche P, Azdad K, Ledent G, Horion J. Selective primary angioplasty following an angiosome model of reperfusion in the treatment of Wagner 1-4 diabetic foot lesions: practice in a multidisciplinary diabetic limb service. J Endovasc Ther. 2008 Oct;15(5):580-93. doi: 10.1583/08-2460.1.
- Background: PubMed 2670609Lukkari-Rautiarinen E, Lepantalo M, Pietila J. Reproducibility of skin blood flow, perfusion pressure and oxygen tension measurements in advanced lower limb ischaemia. Eur J Vasc Surg. 1989 Aug;3(4):345-50. doi: 10.1016/s0950-821x(89)80072-6.
- Background: PubMed 20888247Beiderman Y, Amsel AD, Tzadka Y, Fixler D, Mico V, Garcia J, Teicher M, Zalevsky Z. A microscope configuration for nanometer 3-D movement monitoring accuracy. Micron. 2011 Jun;42(4):366-75. doi: 10.1016/j.micron.2010.05.020. Epub 2010 Sep 19.
- Background: PubMed 19997398Zalevsky Z, Beiderman Y, Margalit I, Gingold S, Teicher M, Mico V, Garcia J. Simultaneous remote extraction of multiple speech sources and heart beats from secondary speckles pattern. Opt Express. 2009 Nov 23;17(24):21566-80. doi: 10.1364/OE.17.021566.
- Background: PubMed 21198155Beiderman Y, Horovitz I, Burshtein N, Teicher M, Garcia J, Mico V, Zalevsky Z. Remote estimation of blood pulse pressure via temporal tracking of reflected secondary speckles pattern. J Biomed Opt. 2010 Nov-Dec;15(6):061707. doi: 10.1117/1.3505008.
- Background: PubMed 21483609Beiderman Y, Blumenberg R, Rabani N, Teicher M, Garcia J, Mico V, Zalevsky Z. Demonstration of remote optical measurement configuration that correlates to glucose concentration in blood. Biomed Opt Express. 2011 Mar 14;2(4):858-70. doi: 10.1364/BOE.2.000858.
- Background: PubMed 24940550Ozana N, Arbel N, Beiderman Y, Mico V, Sanz M, Garcia J, Anand A, Javidi B, Epstein Y, Zalevsky Z. Improved noncontact optical sensor for detection of glucose concentration and indication of dehydration level. Biomed Opt Express. 2014 May 22;5(6):1926-40. doi: 10.1364/BOE.5.001926. eCollection 2014 Jun 1.
- Background: PubMed 24503638Margalit I, Beiderman Y, Skaat A, Rosenfeld E, Belkin M, Tornow RP, Mico V, Garcia J, Zalevsky Z. New method for remote and repeatable monitoring of intraocular pressure variations. J Biomed Opt. 2014 Feb;19(2):027002. doi: 10.1117/1.JBO.19.2.027002.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Meir Nyska, Prof. study director
Head of the orthopaedic department
Questions about this trial
What is this clinical trial studying?
A study testing TcPO2 and Green laser (at 532nm) and a fast camera in people with Diabetic Ulcer and Perfusion, run by Meir Medical Center.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 8 Feb 2017. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Omer Slevin, M.D. (0545563036 ext. 972, omerslevin@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Correlation between TcPO2 results and reflected secondary speckle patterns (time frame: through study completion, an average of 1 year). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03046628, which also lists 13 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Feb 2017.