Primary Outcome Measures:
- The time to complete wound closure as assessed by the investigating physician [ Time Frame: Measured up to Day 28 ] [ Designated as safety issue: No ]
Secondary Outcome Measures:
- Local wound tolerability [ Time Frame: Up to Day 28 after surgery ] [ Designated as safety issue: Yes ]
Split thickness skin grafting is the transplantation of a patient's own cutaneous tissue harvested from an area of normal skin, to replace an area of skin loss or injury. The split thickness skin graft (SSG) is one of the most commonly performed operations in plastic and reconstructive surgery1. Indications for split skin grafting include: reconstruction after the surgical removal of cutaneous malignancies, to replace tissue lost in full-thickness burns and to cover chronic non-healing cutaneous ulcers. As with all grafting procedures, a donor site wound is created, and, in the case of SSGs, the wound is a partial-thickness wound that heals by re-epithelialisation. Often, the graft donor site is the slowest to heal, and it is the source of most of the postoperative discomfort. In patients who have sustained major burns affecting large percentages of their cutaneous surface area, early closure of burn wounds with autologous skin grafts can be limited by the lack of adequate donor sites. These donor sites may need to be re-harvested to provide further skin cover; however a delay of 2 to 3 weeks is often required to allow these sites to heal prior to re-harvesting.
A treatment to accelerate the healing of SSG donor sites produced after harvest would address an area of high medical need, not only by providing an area available for re-harvest, but also by reducing the potential associated morbidities to the patient including pain and infection. This could also reduce length of hospital stay with associated reduced healthcare costs.
Transforming growth factor betas (TGF-beta), are a naturally occurring protein which plays a central role in the wound healing response. Juvidex is being developed by Renovo as a therapeutic agent administered to accelerate the healing of acute wounds. The proposed mechanism of action is antagonistic and involves inhibiting the activation of TGF-beta 1 and TGF beta 2.
Using healthy volunteers is an ideal way of studying the healing process on split thickness skin graft donor sites since the donor sites can be created so that they are exactly anatomically matched. These matched pairs can then be used to compare drug against placebo.
The trial is being undertaken to assess the effects of intradermally injected and topically applied Juvidex on the healing of small skin graft donor sites in volunteer subjects. The trial will also compare the effects of a placebo treatment with standard care alone in the healing of the donor sites. This will enable any placebo effect to be accurately measured and allow an accurate assessment of actual drug effect.