This trial is active, not recruiting.

Conditions venous insufficiency, venous reflux, lower extremity ulcer
Treatment mist therapy
Sponsor Celleration, Inc.
Start date April 2012
End date May 2014
Trial size 156 participants
Trial identifier NCT01549860, IN-BALANCE VLU


This trial is a prospective, randomized, controlled, multi-center study of subjects presenting with chronic lower extremity venous ulcers. The study will evaluate the safety and effectiveness of MIST Therapy® plus standard of care (MIST+SOC) compared to Standard of Care (SOC) alone in the treatment of lower extremity venous ulcers.

United States No locations recruiting
Other countries No locations recruiting

Study Design

Allocation randomized
Endpoint classification efficacy study
Intervention model parallel assignment
Masking single blind (outcomes assessor)
Primary purpose treatment
(No Intervention)
30 to 40 mmHg compression, dressing for moist wound healing environment, debridement as needed. Minimum of one treatment per week and up to 3 times per week per investigator discretion for 4 weeks
30 to 40 mmHg compression, dressing for moist wound healing environment, debridement as needed plus non-contract low frequency ultrasound 3 x per week for 4 weeks.
mist therapy
Non-contact low frequency ultrasound therapy

Primary Outcomes

Wound Area Reduction
time frame: 4 weeks post randomization

Secondary Outcomes

Time to heal
time frame: 12 weeks post randomization
Wound Recidivism Rates
time frame: 12 Months Post Heal
Pain Level
time frame: Baseline, 2 weeks and 4 weeks post randomization
time frame: Baseline and 4 Weeks post randomization
Wound Area Reduction Stratified by Wound Age
time frame: 4 weeks post randomization
Wound Area Reduction Stratified by Wound Size
time frame: 4 weeks post randomization

Eligibility Criteria

Male or female participants from 18 years up to 90 years old.

Inclusion Criteria: - Lower extremity full thickness venous ulcer of > 30 days duration - Subject's wound must be between 4 cm² and 50 cm² at screening - Documented ABI that is between 0.8 and 1.2 on the study limb or transcutaneous partial pressure oxygen (TcpO2) > 40 mmHG; or a toe pressure > 40 mmHG; or a Doppler waveform consistent with adequate flow in the foot (biphasic or triphasic waveforms) at time of screening - Biopsy for wounds > 6 months duration - Documented index wound etiology of venous stasis with reflux and /or incompetent valves Exclusion Criteria: - Index ulcer wound that is less than 1 cm in distance from another ulcer wound - > 5 ulcers on the index leg - Index ulcer wound has exposed tendons, ligaments, muscle, or bone - Index ulcer wound presents with clinical signs of acute infection, suspected or known - Subjects with evidence of osteomyelitis or cellulitis or gangrene in the study limb - Subjects with amputation above a Trans Metatarsal Amputation (TMA) in the study limb - Subjects with active malignancy on the study limb except non-melanoma skin cancer - Index ulcer that is of arterial disease etiology - Index ulcer of other primary etiology (ie. vasculitis, arterial, pyoderma) - Subjects with planned vascular surgery, angioplasty or thrombolysis procedures within the study treatment phase - Subjects with planned surgical procedure during the study treatment phase for the index wound including skin flap or skin graft - Subjects within 6 weeks postoperatively of a vascular o skin graft procedure. - Subject has had prior skin replacement, negative pressure therapy, or traditional ultrasound therapy applied to the index wound in the 14 days prior to screening - Subject has had ultrasound treatment (including MIST Therapy) of the index wound. - Subject has received growth factor therapy (e.g., autologous platelet-rich plasma gel, becaplermin, bilayered cell therapy, dermal substitute, extracellular matrix) within 14 days of screening date. - Subject is currently receiving or has received radiation or chemotherapy within 3 months of randomization. - Female subjects that are pregnant or refuse to utilize adequate contraceptive methods and are of childbearing age during the trial. - Subject has one or more medical condition(s), uncontrolled diabetes (i.e. HbA1c > 12), renal, hepatic, hematologic, neurologic, or immune disease that in the opinion of the investigator would make the subject an inappropriate study candidate - Subject's wound would require ultrasound near an electronic implant or prosthesis - Subject is known to be suffering from a disorder or other situation that the subject or investigator feels would interfere with compliance or other study requirements - Subject is currently enrolled or has been enrolled in the last 30 days in another investigational device or drug trial

Additional Information

Official title IN-BALANCE VLU Inflammation, Bacteria, & Angiogenesis Effects in Launching Venous Leg Ulcer Healing
Principal investigator Gary Gibbons, MD
Description The study compared the treatment effect of non-contact low frequency ultrasound in addition to standard of care versus standard of care alone in healing chronic venous leg ulcers in subjects who had documented venous stasis and reflux. Subjects that were screened and met the major inclusion criteria received standardized treatment of 30 to 40 mmHg compression, moist wound healing dressings, and debridement for a two week run-in period. If their study ulcer did not decreased by greater than 30% they were eligible for randomization. The primary endpoint was wound area reduction after four (4) weeks of study treatment. The study was performed at 22 study centers. The study included two sub-studies: fluid and tissue analysis and a wound recidivism registry that are ongoing.
Trial information was received from ClinicalTrials.gov and was last updated in August 2014.
Information provided to ClinicalTrials.gov by Celleration, Inc..