About this trial
This is a randomised, unblinded interventional device proof of concept pilot trial in which patients undergoing nasal surgery will be selected for either photodisinfection therapy (PDT) with the Steriwave™ ND System, or control with nares swabbed with 'photosensitizer formulation' preoperatively.
This trial will primarily assess the safety and efficacy of nasal photodisinfection treatment in decreasing post-operative events in patients undergoing nasal surgery. After signing informed consent, and before surgery, participants will receive a baseline culture of the anterior nares to determine nasal bacterial colonization and will have a flexible nasendoscopy to determine their Lund-Kennedy (LK) endoscopic score. Subjects will then be randomised to nasal PDT (which includes two applications of 'photosensitizer formulation' \[0.01% methylene blue with 0.25% chlorhexidine solution\], two minutes apart), along with light therapy, or control with nares swabbed twice with 'photosensitizer formulation' with two minutes in between (no light therapy). Following treatment, participants will be re-cultured (2 weeks after the surgery ± 7 days) and reviewed for antibiotic use and surgical site infection (SSI) using LK endoscopic scoring. At 30 days, all participants will be followed up by telephone to review if they received antibiotics for presumed postoperative infection. Standard post-operative care will be provided according to the type of surgery performed. Any required interventions post-operatively will be documented.
Eligibility criteria
Qualifiers
Patients ≥ 16 years
Endoscopic Sinus Surgery (ESS) with or without adjunctive Septoplasty and/or Turbinoplasty
Septoplasty with or without adjunctive Turbinoplasty
Closed Septoplasty with or without adjunctive Turbinoplasty
Disqualifiers
Congenital or acquired immunodeficiency, bone marrow disease, diabetes, autoimmune conditions requiring immunosuppressive treatment, any immunosuppressive medication at the time of consent or within the last 4 weeks before randomisation
Primary or secondary ciliary dyskinesia, cystic fibrosis
Patients who have received antibiotics within a week before randomisation
Patients who receive prophylactic antibiotics or antibiotics prior to discharge
Trial design
Treatments tested in this trial
- Nasal PDT
- Photosensitizer formulation only
- Standard follow-up
- Nasal culture
- Flexible nasendoscopy
- In-person review
- Telephone Follow-up
Treatment groups
Locations
1Sponsors and collaborators
Guy's and St Thomas' NHS Foundation Trust
Lead sponsor