Cesarean SectionNCT04884919
Develop the First Aid Medical Supplies for Hemostasis and Bacteriostasis With Clinical Trial
A study testing Regular Gauze and Chitosan Dressing in people with Cesarean Section, run by Tri-Service General Hospital (TSGH) at 1 site in Taiwan.
Trial summary
The current development of hemostatic and open wound infection care strategies will focus on enhancing the efficiency of hemostasis for internal bleeding, relieving pain, avoiding wound infection, and promoting wound healing. Read more about this study
- Who is it for?
- Ages 20 to 80 years
- Conditions the study is for
- Cesarean Section
- What is being tested?
- Regular Gauze and Chitosan Dressing
- Type of treatment
- Medical device
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 40 participants
- Where
- 1 siteTaiwan
- Study dates
- 10 May 2019to 31 Dec 2021
- 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 20 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- The subject is aged between 20 and 80 years old.
- Patients who need a cesarean section.
- The expected size of the wound is about 5 cm or more in length and 2 cm or more in width.
Who cannot join
- Patients with a history of allergy to chitin components such as shrimp and crab.
- Patients with blood clotting disorders.
- Vulnerable groups.
- Patients with unstable signs of life.
Trial locations and contacts
1 site in 1 country.
Taiwan1 site, 1 recruiting
- Recruiting
National Defense of Medical Center, Tri-Service General Hospital
Taipei, 114
Sheng-Der Hsu, 886-987860386, f1233j@yahoo.com.tw
Ya-Chi Liu, 886-2-87923100 ext. 18681, hotcgin0067@gmail.com
About this study
The current development of hemostatic and open wound infection care strategies will focus on enhancing the efficiency of hemostasis for internal bleeding, relieving pain, avoiding wound infection, and promoting wound healing. As the social environment changes, the demand for hemostatic techniques and wound healing is increasing. Thus, hemostatic techniques are needed to be integrated with functional functions for usual trauma care, and the wound care strategies that can inhibit and reduce infection while helping to facilitate wound healing are needed to be developed to ensure the safety of human life. Therefore, this trial aims to develop new biofiber hemostatic dressings for hemostasis and open wound care. The comparisons of hemostatic and antibacterial effects, hemostatic time, wound infection status, wound bacteria count, and wound adhesion situation obtained from this clinical trial are expected able to establish a better rapid hemostatic strategy and wound infection care strategy.
Read the detailed description
This trial is performed when the subjects undergoing a cesarean section at Tri-Service General Hospital, Taipei, Taiwan (R.O.C). After disinfection of the surgical wound, regular gauze and chitosan dressings are directly and simultaneously placed over the disinfected wound with finger pressure for 3 min, immediately after the dissection. The regular gauze dressing is placed on half side of the surgical wound, while the chitosan dressing is placed on another half side of the wound. After 3 min, the pressure is stopped and the doctors will photograph and observe both dressings whether the bleeding has stopped. If the bleeding on the surface of the wound has stopped after 20 s, the bleeding is considered to have stopped and the wound is then treated according to the scheduled surgical procedure. If the bleeding has not stopped, finger pressure to stop bleeding will be given for 5 min. Then, after 5 minutes, the pressure is stopped and the bleeding condition is observed. If the bleeding has stopped after 20 s, the bleeding of the wound is judged to have stopped and the subsequent surgery will be performed. However, if it still bleeds, both dressings will be replaced and do the same for another 5 min. (Note) Depending on the physiological parameters of each patient, the decision can be determined by the physician; if bleeding or hematoma occurs, the patient will be treated according to hospital procedure until the symptoms are relieved, and evaluate whether the test should be stopped.
The postoperative wound will be dressed with regular gauze and chitosan dressings and the wound condition will be recorded on day 0 of the trial. The dressing is daily changed by replacing regular gauze and chitosan dressings and by performing wound care. The test of the dressing sample will be taken for bacterial analysis. If there are symptoms of infection after 14 days of this test, the wound will be treated in accordance with the clinical routine wound treatment. (Note) If the wound condition shows serious infection during the dressing change process, the treatment should be carried out according to the clinical routine treatment method, and it is determined and evaluated whether to stop the test. (Note) If the patient's psychological stress is affected during the trial, the physician will explain and determine whether the trial must be stopped.
- Conditions
- Cesarean Section
- Being tested
- Regular Gauze, Chitosan Dressing
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Regular GauzeDevice
Regular gauze
Chitosan DressingDevice
Dressing made of chitosan material
| Study group | Role | What they receive |
|---|---|---|
| Regular Gauze Treatment | Placebo comparator | Participants who undergo a cesarean section are first dissected in about 5 cm length and 2 cm width and receive a regular gauze made of traditional cotton yarn. The regular gauze is applied on the half side of the wound. Receives: Device: Regular Gauze |
| Chitosan Dressing Treatment | Experimental | Participants who undergo a cesarean section are first dissected in about 5 cm length and 2 cm width and receive a chitosan dressing made of chitosan material. The chitosan dressing is applied on another half side of the wound. Receives: Device: Chitosan Dressing |
What is being measured
The primary outcome is the main question the study is designed to answer.
Hemoglobin Assay
After 3, 5, and additional 5 minutes, consecutively depending on the patients' conditions, the use of regular gauze and chitosan dressings to compress the abdominal surgical wounds are incubated in jars containing 0.9% (w/v) saline solution for 1, 3, 5, and 10 minutes, respectively. 1 mL solution of the dressing incubation is collected and evaluated using a hemoglobin standard (H7379, Sigma-Aldrich; Merck KGaA, Darmstadt, Germany). The hemoglobin concentration is measured by examining the optical density at 540 nm wavelength.
Measured: 3 up to 13 minutes
Adenosine Triphosphate (ATP) Assay
This assay is performed to evaluate and compare antimicrobial properties of both dressings. Adenosine triphosphate (ATP) bioluminescence assay expressed in Relative Fluorescence Units (RFU) is used to measure the number of bacteria by using ATP luminometer (LuciPac Pen PD 30, Kikkoman Biochemifa Co., Tokyo, Japan).
Measured: Up to 8 days
Phylogenetic of Microbial Community
Wound-contacted dressings of patients are collected on day 1 and day 3 postoperation and kept at 4°C within an hour processed for genomic DNA isolation using DNeasy Blood \& Tissue kit (QIAGEN, Germany). Amplification of 16S-rRNA-genes of distinct regions V3-V4 is conducted using specific primer 16S V3+V4: 314F-806R with the barcode. Phusion® High-Fidelity PCR Master Mix (New England Biolabs) is then used for all PCR reactions. Subsequently, 300bp paired-end raw reads are implemented for amplicon sequencing. Finally, the entire paired-end reads are incorporated using FLASH v.1.2.7.
Measured: Up to 3 days
Heat Map Analysis
The heat map is analyzed using an R package to acquire the distribution of bacteria population in wound-contacted dressings. This analysis results the distribution of heat produced by bacteria population that is scaled from -1 to 1 indicating the abundance of each genus of bacteria from the lowest temperature to the highest temperature.
Measured: Up to 6 days
Partial Least Squares Discriminant Analysis (PLS-DA)
PLS-DA is analyzed using PLS toolbox (Eigenvector Research Incorporated Wenatchee, WA, USA) for Matlab® R2009b software (Mathworks Inc., Natick MA, USA) to get the discriminant of bacterial community between the wound-contacted dressing.
Measured: Up to 6 days
UpSet Plot
The UpSet plot of Bacteria Operational Taxonomy Units is produced in R using UpSetR. This results intersection sizes of bacteria among the experiment groups.
Measured: Up to 6 days
Statistical Analysis
Statistical calculations are performed using SPSS software version 21 (SPSS, Chicago, IL, USA) and written in the form of mean ± standard error of the mean. Data means are compared by one-way or two-way analysis of variance (ANOVA) among two or more than two groups for statistical comparison. The significance level is set at p < 0.05.
Measured: Up to 8 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 May 2021
- Study start10 May 2019
- Primary completion31 Dec 2021 (estimated)
- Study completion31 Dec 2021 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (6)Papers the sponsor has linked to this study.
- Other trials for Cesarean SectionStudies 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
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Model description
- Each of the participants is treated with 2 different treatments on different areas of the same wound at the same time.
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 40 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Tri-Service General Hospital (TSGH)
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Hsu Sheng-Der, Tri-Service General Hospital (TSGH)
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04884919
- Sponsor's protocol ID
- Chitosan-Microbiome
- Status last verified
- May 2021
- First submitted
- 2 May 2021
- Last updated
- 13 May 2021
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Kang X, Liu G, Liu Y, Xu Q, Zhang M, Fang M. Transcriptome profile at different physiological stages reveals potential mode for curly fleece in Chinese tan sheep. PLoS One. 2013 Aug 26;8(8):e71763. doi: 10.1371/journal.pone.0071763. eCollection 2013.
PubMed 23990983Chen B, Gao LL, Pan Q. Woody forages effect the intestinal bacteria diversity of golden pompano Trachinotus ovatus. AMB Express. 2018 Feb 27;8(1):29. doi: 10.1186/s13568-018-0550-2.
PubMed 29484505Vijayalakshmi S, Adeyemi DE, Choi IY, Sultan G, Madar IH, Park MK. Comprehensive in silico analysis of lactic acid bacteria for the selection of desirable probiotics. LWT. 2020; 130:109617.
Akanny, E, Bonhommé, A, Commun, C, et al. Surface-enhanced Raman spectroscopy using uncoated gold nanoparticles for bacteria discrimination. J Raman Spectrosc. 2020; 51: 619- 629.
Ramadan Z, Jacobs D, Grigorov M, Kochhar S. Metabolic profiling using principal component analysis, discriminant partial least squares, and genetic algorithms. Talanta. 2006 Feb 28;68(5):1683-91. doi: 10.1016/j.talanta.2005.08.042. Epub 2005 Sep 19.
PubMed 18970515Ruparell A, Inui T, Staunton R, Wallis C, Deusch O, Holcombe LJ. The canine oral microbiome: variation in bacterial populations across different niches. BMC Microbiol. 2020 Feb 28;20(1):42. doi: 10.1186/s12866-020-1704-3.
PubMed 32111160
Study at a glance
From the registry record, last updated by the sponsor on 13 May 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Develop the First Aid Medical Supplies for Hemostasis and Bacteriostasis With Clinical Trial
- ClinicalTrials.gov ID
- NCT04884919
- Acronym / sponsor ID
- Chitosan-Microbiome
- Conditions
- Cesarean Section
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 40 participants (estimated)
- Lead sponsor
- Tri-Service General Hospital (TSGH)University, hospital or other
- Study start
- 10 May 2019 (actual)
- Primary completion
- 31 Dec 2021 (estimated)
- Study completion
- 31 Dec 2021 (estimated)
- First posted
- 13 May 2021 (actual)
- 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 current development of hemostatic and open wound infection care strategies will focus on enhancing the efficiency of hemostasis for internal bleeding, relieving pain, avoiding wound infection, and promoting wound healing. As the social environment changes, the demand for hemostatic techniques and wound healing is increasing. Thus, hemostatic techniques are needed to be integrated with functional functions for usual trauma care, and the wound care strategies that can inhibit and reduce infection while helping to facilitate wound healing are needed to be developed to ensure the safety of human life. Therefore, this trial aims to develop new biofiber hemostatic dressings for hemostasis and open wound care. The comparisons of hemostatic and antibacterial effects, hemostatic time, wound infection status, wound bacteria count, and wound adhesion situation obtained from this clinical trial are expected able to establish a better rapid hemostatic strategy and wound infection care strategy.
Detailed description
This trial is performed when the subjects undergoing a cesarean section at Tri-Service General Hospital, Taipei, Taiwan (R.O.C). After disinfection of the surgical wound, regular gauze and chitosan dressings are directly and simultaneously placed over the disinfected wound with finger pressure for 3 min, immediately after the dissection. The regular gauze dressing is placed on half side of the surgical wound, while the chitosan dressing is placed on another half side of the wound. After 3 min, the pressure is stopped and the doctors will photograph and observe both dressings whether the bleeding has stopped. If the bleeding on the surface of the wound has stopped after 20 s, the bleeding is considered to have stopped and the wound is then treated according to the scheduled surgical procedure. If the bleeding has not stopped, finger pressure to stop bleeding will be given for 5 min. Then, after 5 minutes, the pressure is stopped and the bleeding condition is observed. If the bleeding has stopped after 20 s, the bleeding of the wound is judged to have stopped and the subsequent surgery will be performed. However, if it still bleeds, both dressings will be replaced and do the same for another 5 min. (Note) Depending on the physiological parameters of each patient, the decision can be determined by the physician; if bleeding or hematoma occurs, the patient will be treated according to hospital procedure until the symptoms are relieved, and evaluate whether the test should be stopped.
The postoperative wound will be dressed with regular gauze and chitosan dressings and the wound condition will be recorded on day 0 of the trial. The dressing is daily changed by replacing regular gauze and chitosan dressings and by performing wound care. The test of the dressing sample will be taken for bacterial analysis. If there are symptoms of infection after 14 days of this test, the wound will be treated in accordance with the clinical routine wound treatment. (Note) If the wound condition shows serious infection during the dressing change process, the treatment should be carried out according to the clinical routine treatment method, and it is determined and evaluated whether to stop the test. (Note) If the patient's psychological stress is affected during the trial, the physician will explain and determine whether the trial must be stopped.
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
- Model description
- Each of the participants is treated with 2 different treatments on different areas of the same wound at the same time.
| Arm | Type | Receives |
|---|---|---|
| Regular Gauze Treatment | Placebo comparator | Device: Regular GauzeParticipants who undergo a cesarean section are first dissected in about 5 cm length and 2 cm width and receive a regular gauze made of traditional cotton yarn. The regular gauze is applied on the half side of the wound. |
| Chitosan Dressing Treatment | Experimental | Device: Chitosan DressingParticipants who undergo a cesarean section are first dissected in about 5 cm length and 2 cm width and receive a chitosan dressing made of chitosan material. The chitosan dressing is applied on another half side of the wound. |
Who may qualify
- Ages
- 20 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- The subject is aged between 20 and 80 years old.
- Patients who need a cesarean section.
- The expected size of the wound is about 5 cm or more in length and 2 cm or more in width.
Key exclusion criteria (4 listed)
- Patients with a history of allergy to chitin components such as shrimp and crab.
- Patients with blood clotting disorders.
- Vulnerable groups.
- Patients with unstable signs of life.
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 |
|---|---|---|
| Regular GauzeRegular gauze | Device | Regular Gauze Treatment |
| Chitosan DressingDressing made of chitosan material | Device | Chitosan Dressing Treatment |
Primary outcome
Hemoglobin Assay
Time frame: 3 up to 13 minutes
After 3, 5, and additional 5 minutes, consecutively depending on the patients' conditions, the use of regular gauze and chitosan dressings to compress the abdominal surgical wounds are incubated in jars containing 0.9% (w/v) saline solution for 1, 3, 5, and 10 minutes, respectively. 1 mL solution of the dressing incubation is collected and evaluated using a hemoglobin standard (H7379, Sigma-Aldrich; Merck KGaA, Darmstadt, Germany). The hemoglobin concentration is measured by examining the optical density at 540 nm wavelength.
Adenosine Triphosphate (ATP) Assay
Time frame: Up to 8 days
This assay is performed to evaluate and compare antimicrobial properties of both dressings. Adenosine triphosphate (ATP) bioluminescence assay expressed in Relative Fluorescence Units (RFU) is used to measure the number of bacteria by using ATP luminometer (LuciPac Pen PD 30, Kikkoman Biochemifa Co., Tokyo, Japan).
Phylogenetic of Microbial Community
Time frame: Up to 3 days
Wound-contacted dressings of patients are collected on day 1 and day 3 postoperation and kept at 4°C within an hour processed for genomic DNA isolation using DNeasy Blood \& Tissue kit (QIAGEN, Germany). Amplification of 16S-rRNA-genes of distinct regions V3-V4 is conducted using specific primer 16S V3+V4: 314F-806R with the barcode. Phusion® High-Fidelity PCR Master Mix (New England Biolabs) is then used for all PCR reactions. Subsequently, 300bp paired-end raw reads are implemented for amplicon sequencing. Finally, the entire paired-end reads are incorporated using FLASH v.1.2.7.
Heat Map Analysis
Time frame: Up to 6 days
The heat map is analyzed using an R package to acquire the distribution of bacteria population in wound-contacted dressings. This analysis results the distribution of heat produced by bacteria population that is scaled from -1 to 1 indicating the abundance of each genus of bacteria from the lowest temperature to the highest temperature.
Partial Least Squares Discriminant Analysis (PLS-DA)
Time frame: Up to 6 days
PLS-DA is analyzed using PLS toolbox (Eigenvector Research Incorporated Wenatchee, WA, USA) for Matlab® R2009b software (Mathworks Inc., Natick MA, USA) to get the discriminant of bacterial community between the wound-contacted dressing.
UpSet Plot
Time frame: Up to 6 days
The UpSet plot of Bacteria Operational Taxonomy Units is produced in R using UpSetR. This results intersection sizes of bacteria among the experiment groups.
Statistical Analysis
Time frame: Up to 8 days
Statistical calculations are performed using SPSS software version 21 (SPSS, Chicago, IL, USA) and written in the form of mean ± standard error of the mean. Data means are compared by one-way or two-way analysis of variance (ANOVA) among two or more than two groups for statistical comparison. The significance level is set at p < 0.05.
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 May 2021.
- Background: PubMed 23990983Kang X, Liu G, Liu Y, Xu Q, Zhang M, Fang M. Transcriptome profile at different physiological stages reveals potential mode for curly fleece in Chinese tan sheep. PLoS One. 2013 Aug 26;8(8):e71763. doi: 10.1371/journal.pone.0071763. eCollection 2013.
- Background: PubMed 29484505Chen B, Gao LL, Pan Q. Woody forages effect the intestinal bacteria diversity of golden pompano Trachinotus ovatus. AMB Express. 2018 Feb 27;8(1):29. doi: 10.1186/s13568-018-0550-2.
- BackgroundVijayalakshmi S, Adeyemi DE, Choi IY, Sultan G, Madar IH, Park MK. Comprehensive in silico analysis of lactic acid bacteria for the selection of desirable probiotics. LWT. 2020; 130:109617.
- BackgroundAkanny, E, Bonhommé, A, Commun, C, et al. Surface-enhanced Raman spectroscopy using uncoated gold nanoparticles for bacteria discrimination. J Raman Spectrosc. 2020; 51: 619- 629.
- Background: PubMed 18970515Ramadan Z, Jacobs D, Grigorov M, Kochhar S. Metabolic profiling using principal component analysis, discriminant partial least squares, and genetic algorithms. Talanta. 2006 Feb 28;68(5):1683-91. doi: 10.1016/j.talanta.2005.08.042. Epub 2005 Sep 19.
- Background: PubMed 32111160Ruparell A, Inui T, Staunton R, Wallis C, Deusch O, Holcombe LJ. The canine oral microbiome: variation in bacterial populations across different niches. BMC Microbiol. 2020 Feb 28;20(1):42. doi: 10.1186/s12866-020-1704-3.
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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.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Regular Gauze and Chitosan Dressing in people with Cesarean Section, run by Tri-Service General Hospital (TSGH) at 1 site in Taiwan.
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 4 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 13 May 2021. 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 Taiwan. 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. Some participants in this study may receive a placebo. 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 Sheng-Der Hsu (886-987860386, f1233j@yahoo.com.tw), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Hemoglobin Assay (time frame: 3 up to 13 minutes). The study lists 7 primary outcomes in all. 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 NCT04884919, which also lists 6 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 13 May 2021.