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NCT05766670PHASE3Recruiting

Intramedullary Calcium Sulfate Antibiotic Depot

Wake Forest University Health Sciences

Start Date

4/8/2024

Completion Date

1/1/2028

Summary

The goal of this randomized clinical trial is to study the best treatment for open lower leg fractures to prevent infection. The main questions it aims to answer is if treating tibia fracture patients with a calcium sulfate antibiotic depot is better at preventing infection that the standard of care.

Detailed Description

This research is a randomized clinical trial aimed to reduce the frequency of fracture related infections following open tibia fracture. The proposed test methods for infection reduction is use of an antibiotic depot placed inside the bone at the time of final fracture treatment. This is in addition to standard of care wound care, fracture fixation with intramedullary nailing, and peri-operative systemic antibiotics. This prospective randomized clinical trial will compare outcomes between patients treated with an antibiotic depot placed inside the bone at the time of final fracture fixation and those treated with traditional standard of care intramedullary nailing. The target population for the proposed study is patients with severe open tibia fractures (Type II or III) who require definitive fixation with intramedullary nail recruited form one of the participating sites during the index hospitalization. One group will be treated prophylactically suing a calcium sulfate antibiotic depot at the time of definitive fixation, while the second group will be treated with a standard of care intramedullary nail without the antibiotic depot. Participants will be followed for 12 months (data capture includes patient interviews and clinical data capture from the treatment team and medical record at baseline, 6 weeks, 3 months, 6 months, and 12 months).

Eligibility Criteria

Age Range: 18 years to No maximum

Inclusion Criteria: * Patients 18 years and older * Type II or III open tibia fracture requiring definitive fixation with intramedullary nail Exclusion Criteria: * Less than 18 years of age * Allergy to vancomycin or tobramycin * Hypercalcemia * Unable to speak English or Spanish * No email, phone, or other point of contact * Pregnant and lactating women * Prisoner

Interventions

DRUG

Vancomycin Hydrochloride

DRUG

Gentamicin

OTHER

Standard Intramedullary Nail

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Conditions

Open tíbia FractureOsteomyelitis TibiaTibial Fractures

Locations

Cedars-Sinai

Los Angeles, California 90048

United States

Atrium Health Navicent The Medical Center

Macon, Georgia 31201

United States

University of Kentucky

Lexington, Kentucky 40508

United States

Louisiana State University Health Sciences Center

New Orleans, Louisiana 70112

United States

Atrium Health Carolinas Medical Center

Charlotte, North Carolina 28204

United States

Atrium Health Cabarrus

Concord, North Carolina 28025

United States

Atrium Health Wake Forest Baptist Medical Center

Winston-Salem, North Carolina 27157

United States

Pennsylvania State University

Hershey, Pennsylvania 17033

United States

Vanderbilt University Medical Center

Nashville, Tennessee 37232

United States

Valley Health

Winchester, Virginia 22601

United States