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Wound of SkinPhase 2/3FTSGNCT03579160

Efficacy and Safety of 0.25% Timolol Gel in Enhancing Full Thickness Skin Grafts Healing and Cosmetic Outcomes

A Phase 2/3 study testing 0.25% timolol gel with full-thickness skin grafts and Vaseline dressing in people with Wound of Skin and Wound Heal, run by Brigham and Women's Hospital at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The use of topical beta-blockers, such as 0.25% timolol, in promoting wound healing is currently emerging in the academic literature. The investigators will enroll 82 patients who have their skin cancer surgically removed resulting in the need of a full-thickness skin graft. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Wound of Skin, Wound Heal, Surgical Wound
What is being tested?
0.25% timolol gel with full-thickness skin grafts and Vaseline dressing
Could I receive a placebo?
No, everyone receives an active treatment
How many people
10 participants
Where
1 siteUnited States
Study dates
2 Jan 2019to 10 Jan 2022
Phase
Phase 2/3
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Age ≥18 years of age
  • Undergoing a procedure which results in the need of a FTSG
  • Willing to provide written informed consent

Who cannot join

  • Age less than 18 years of age
  • Pregnant women
  • (Use of systemic drugs that can impede wound healing, such retinoids or immune-suppressive drugs)
  • Severe coagulation disorders
  • Severe, uncontrolled systemic comorbidities, such as diabetes, arthritis, etc.
  • Hypersensitivity to 0.25% timolol gel
  • Not willing to provide written informed consent

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Mohs and Dermatologic Surgery Center, Brigham and Women's Hospital

    Boston, Massachusetts, 02130

Other trials in United States

About this study

Official title: Efficacy and Safety of 0.25% Timolol Gel in Enhancing Full Thickness Skin Grafts Healing and Cosmetic Outcomes: A Randomized, Controlled Trial

The use of topical beta-blockers, such as 0.25% timolol, in promoting wound healing is currently emerging in the academic literature. The investigators will enroll 82 patients who have their skin cancer surgically removed resulting in the need of a full-thickness skin graft. The objective of this randomized safety study is to determine the safety and efficacy of 0.25% timolol in promoting wound healing in full-thickness skin grafts compared to standard of care.

Read the detailed description

The role of topical beta-blockers in promoting wound healing is currently emerging in the international literature. β2-Adrenergic receptors (B2AR) are the only subtype of beta-adrenoceptors expressed on skin. They can be found in secretory coil of apocrine glands, keratinocytes, fibroblasts and melanocytes. The distribution of these receptors provides insight on dermatological disorders that may be affected by β-blockers. Keratinocyte migration occurs by the facilitation of chemotaxis, the polarization of cells, and activation of extracellular signal-related kinases essential in the signaling of promigratory pathways. The B2AR activation inhibits keratinocyte migration by activating the serine/threonine phosphatase-2a, which downregulates phosphorylation of extracellular signal-related kinases necessary for migration. Therefore, B2AR antagonists prevent the phosphorylation of phosphatase-2a and have the downstream effect of extracellular signal-related kinase promotion, inducing a promigratory pathway in keratinocytes. Keratinocyte migration also occurs by galvanotaxis, a phenomenon in which cells migrate in response to electric stimuli. Keratinocytes can be stimulated to migrate with the formation of electrical poles and the application of electrical fields. The B2AR antagonists improve the ability of keratinocytes to respond to such migratory cues, whereas the B2AR agonists decrease keratinocytes' ability to respond, further implicating the use of topical timolol for recalcitrant wounds. Angiogenesis and dermal fibroblast proliferation are also regulated by B2ARs. The B2AR antagonists have been found to promote angiogenesis in chick chorioallantoic membrane assays and in vivo murine wound models. Dermal fibroblast migration is also increased (by 27%) when exposed to B2AR antagonists, and epidermal differentiation is improved with B2AR antagonists and β1- and β2-receptor antagonists.

Full-thickness skin grafts (FTSG) are one of the most commonly performed procedures in dermatologic, plastic and burn surgery. Various experimental approaches to optimize the healing of FTSG receiving sites have been described; however, no clearly superior and easily applicable method has gained wide acceptance in daily practice.

As indicated by preliminary evidence in other wound healing endeavors, 0.25% timolol gel may represent a commercially available, safe and simple, painless and relatively inexpensive treatment for improving healing of FTSG receiving site, as well as for improving cosmetic long term outcomes.

To assess the efficacy and safety of topically applied 0.25% timolol gel in promoting wound healing in FTSG receiving site versus standard of care (SOC) by:

  1. Evaluating healing in response to treatment with 0.25% topical timolol gel versus SOC in terms of wound surface area and Graft Take Score at the receiving site of a FTSG at 7 and 14 days;
  2. Evaluating cosmetic outcomes of the receiving site of a FTSG in terms of blinded physician (Vancouver Scar Scale, VSS) and patient (Visual Analogue Scale, VAS) assessment at 3 and 6 months' follow up;
  3. Evaluating the need for further scar revision (dermabrasion or pulsed dye laser [PDL]) at the 6-month follow up;
  4. Evaluating patient discomfort during the healing process by means of a patient pain VAS; and
  5. Determining the side effects associated with 0.25% timolol gel versus SOC
Being tested
0.25% timolol gel with full-thickness skin grafts, Vaseline dressing
Medical subject headings
Surgical Wound

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • 0.25% timolol gel with full-thickness skin graftsDrug

    Timolol 0.25% gel will be applied to wound bed immediately after surgery before dressing is applied.

  • Vaseline dressingOther

    Vaseline will be applied to wound bed immediately after surgery before dressing is applied.

Study groups in NCT03579160
Study groupRoleWhat they receive
0.25% Timolol gel applied to full-thickness skin graftExperimental1. During surgery: application of 0.25% timolol gel (2 drops per cm2) on wound bed before FTSG is placed 2. During surgery: application of 0.25% timolol gel (2 drops per cm2) over FTSG after insetting of the graft 3. After bolster removal (7 days): daily cleansing and daily 0.25% timolol (2 drops per cm2) application for 4 weeks
Receives: Drug: 0.25% timolol gel with full-thickness skin grafts
Standard of Care dressingsActive comparator1. FTSG surgery as per SOC 2. After bolster removal (7 days): daily cleansing and daily Vaseline application for 4 weeks
Receives: Other: Vaseline dressing

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Healed Wound Surface in Response to Treatment With 0.25% Topical Timolol Gel Versus SOC in Terms of Wound Surface Area at the Receiving Site of a FTSG Via Histogram Planimetry

    Histogram planimetry is more accessible than automated analysis software programs, and it is based on the pixel count of a selected irregular area which is divided by the pixel count of 1 cm2 to find a result in terms of cm2 or mm2.

    Measured: 7 days post-surgery

Secondary outcomes (4)
  1. Rate of Successful (Completely Healed) Graft in Response to Treatment With 0.25% Topical Timolol Gel Versus SOC Using a Blinded Physician Assessment Score at the Receiving Site of a FTSG at 7 Days

    Physician blinded to subject's treatment group uses VSS which documents scar appearance change over time via photos. VSS ranges from 0 (most desirable outcome) to 13 (least desirable). A lower score is considered a better outcome and a higher score is a worse outcome. VSS consists of 4 sub-scales, with each reporting a value. The "pigmentation" ranges from 0 (normal pigment) to 2 (hyperpigment); "vascularity" ranges from 0 (normal appearance) to 3 (purple appearance); "pliability" ranges from 0 (normal) to 5 (contracture); "height" ranges from 0 (normal/flat) to 3 (>5mm). Sub-scale scores are combined to give an overall VSS score.

    Measured: 7 days post-surgery

  2. Patient Discomfort During the Healing Process by Means of a Patient Pain VAS

    Subjects will be asked to complete a Visual Analogue Scale for scar assessment to rate how they think their graft sites appear cosmetically compared to normal skin, and any complaints about how painful they sites are, and how itchy they feel. The score ranges from 1 to 10. A lower score is considered to have a better outcome and a higher score is considered a worse outcome.

    Measured: 7 days' post-surgery

  3. Number of Participants With Side Effects Associated With 0.25% Timolol Gel Versus SOC Via Physician Assessment

    A physician will assess for side effects and determine whether they are likely associated with the 0.25% topical timolol or part of the normal wound healing experience.

    Measured: 7 days' post-surgery

  4. Number of Participants With Side Effects Associated With 0.25% Timolol Gel Versus SOC Via Patient Assessment

    Patients will report any side effects they experience post-surgery

    Measured: 7 days' post-surgery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Jul 2018
  2. Study start2 Jan 2019
  3. Primary completion10 Jan 2022
  4. Study completion10 Jan 2022

Why it stopped: Due to the insufficient accrual rate and strategic reasons to focus our efforts on higher impact research projects.

Resources

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 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
The protocol will begin post-surgery. Eligible subjects will be assigned by computer-based randomization to case (0.25% timolol gel) or control (standard of care \[SOC\]) group and treated as follows: Receiving site of FTSG/case group: 1. During surgery: application of 0.25% timolol gel (2 drops per cm2) on wound bed before FTSG is placed 2. During surgery: application of 0.25% timolol gel (2 drops per cm2) over FTSG after insetting of the graft 3. After bolster removal (7 days): daily cleansing and daily 0.25% timolol (2 drops per cm2) application for 4 weeks Receiving site of FTSG/control group: 1. FTSG surgery as per SOC 2. After bolster removal (7 days): daily cleansing and daily Vaseline application for 4 weeks
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
10 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03579160
Sponsor's protocol ID
BWHMDSC003
Acronym
FTSG
Status last verified
Mar 2026
First submitted
7 Jun 2018
Last updated
9 Jun 2026
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing 0.25% timolol gel with full-thickness skin grafts and Vaseline dressing in people with Wound of Skin and Wound Heal, run by Brigham and Women's Hospital at 1 site in United States.

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 3 inclusion and 7 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: stopped early, as of the sponsor's last update on 9 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

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.

What does this combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 9 Jun 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Healed Wound Surface in Response to Treatment With 0.25% Topical Timolol Gel Versus SOC in Terms of Wound Surface Area at the Receiving Site of a FTSG Via Histogram Planimetry (time frame: 7 days post-surgery). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 9 Jun 2026.

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