Prophylactic Antibiotic Coated Nail to Prevent Infection: A Clinical Trial

Trial statusRecruiting
Trial phasePhase 4
Trial typeInterventional
Biological sexAll
Age18+
SponsorWake Forest University Health Sciences

About this trial

This prospective randomized clinical trial will compare outcomes between patients treated primarily with a prophylactic antibiotic coated nail and those treated with traditional standard of care intramedullary (IM) nailing.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Patients 18 years or older

Gustilo Type II or III open tibia fracture requiring definitive fixation with intramedullary nail

Disqualifiers

Less than 18 years of age

Allergy to vancomycin or gentamicin

Unable to speak English or Spanish

Pregnant and lactating women

Trial design

Design model

Parallel

Treatments tested in this trial

  • Antibiotic coated intramedullary Nail

    Drug

    Antibiotic coated intramedullary nail: A mixture of 40gm bag of acrylic cement, antibiotic powder (Vancomycin 2gm) and 560mg gentamicin liquid. The intramedullary is coated with the mixture using a cement gun tube.

  • Standard Intramedullary Nail

    Other intervention

    Standard Intramedullary Nail

Treatment groups

242 Participants
are divided into 2 treatment groups
Group A: Intramedullary NailActive comparator 1 intervention
Group B: Antibiotic Coated Intramedullary NailActive comparator 1 intervention

Trial outcomes

Primary outcomes

1

Number of Participants who develop deep surgical site infection (SSI)

Number of participants in each group who develop SSI as defined by the criteria establish by the Centers for Disease Control and Prevention (CDC). The CDC criteria define deep as occurring within 30 or 90 days after the procedure. However, we will continue to follow patients for 12 months and document any infections and other complications during this period.

Time frame
Day 30 through month 12

Secondary outcomes

1

Radiographic Union Scale in Tibial fractures (RUST) score

The RUST score ranges from a minimum score of 4 (definitely not healed) to a maximum score of 12 (completely healed). The final x-ray obtained within a 12-month period following injury will be uploaded to REDCap for review by a blinded panel of investigators from participating sites.

Time frame
week 6, month 3, month 6, and month 12
2

Percentage of Union

Union is the gradual process of bone regeneration after a fracture. Percentage of Union, as determined by the treating surgeon, will be assessed via radiographs. Recorded by surgeon as yes/no answers.

Time frame
week 6, month 3, month 6 and month12
3

Time to Union

Captured in days

Time frame
week 6, month 3, month 6 and month12
4

Average Time to Return to Work/Duty

number of days

Time frame
week 6, month 3, month 6 and month12

Other outcomes

Sponsors and contacts

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