Health Trials

About this trial

This is a multi-center, pragmatic, parallel arm randomized controlled trial (RCT) of 352 patients with high-risk open or closed tibial plateau fracture, high-risk open or closed tibial pilon fracture, or open tibial shaft fracture with incision \>3cm. Eligible participants will be randomized to receive either incisional negative pressure wound therapy (NPWT) or a non-suction standard-of-care wound dressing for their definitive wound management. The primary outcome will be a composite outcome to evaluate clinical status 3 months after randomization.

Eligibility criteria

Qualifiers

All open or closed tibial plateau or pilon fractures treated operatively with internal fixation at high risk for complication. Any open Gustilo Type I, II or IIIA tibial shaft fracture treated definitively with internal or external fixation with or without ipsilateral leg compartment syndrome if at least one wound is primarily closed.

Closed fracture initially treated with an external fixator (with or without limited internal fixation) and treated definitive more than 3 days later after swelling has resolved;

Any open type I, II or IIIA fracture, regardless of timing of definitive treatment;

Any tibial plateau fracture associated with ipsilateral leg compartment syndrome fasciotomy wounds that has at least one wound primarily closed

Disqualifiers

The study injury is already infected at time of study enrollment.

Patient is unable to receive incisional NPWT for any reason.

Patients who have already had definitive fixation prior to enrollment in the study.

Severe problems with maintaining follow-up (e.g., patients who are homeless at the time of injury or those who are intellectually challenged without adequate family support or who are prisoners).

Trial design

Treatments tested in this trial

  • Incisional Negative Pressure Wound Therapy (NPWT)

Treatment groups

352 Participants
are divided into 2 treatment groups

Locations

6
University of Maryland R Adams Cowley Shock Trauma Center21201, BaltimoreMaryland, United States
University of Maryland Shock Trauma/Capitol Regions21201, BaltimoreMaryland, United States
Dartmouth-Hitchcock Medical Center03756, LebanonNew Hampshire, United States
Vanderbilt University37232, NashvilleTennessee, United States

Sponsors and collaborators

Major Extremity Trauma Research Consortium

Lead sponsor

Source ClinicalTrials.gov