Accelerated Flap Coverage for Severe Lower Limb Injuries
Accelerated Flap Coverage in Severe Lower Extremity Trauma
Recruiting
N/AInterventional Study
Open Tibia FractureOpen Dislocation of AnkleExtremity Fracture LowerExtremity Injuries Lower
No Placebo Group
Every participant receives an active treatment — no one gets a placebo.
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Review the details below, then apply to join this clinical trial.
At a Glance
Age
18 and older
Sex
Any
Study type
Interventional
Purpose
Treatment
Participants needed
356 (estimated)
Sponsor
Johns Hopkins University · Other
Who this trial is looking for
This trial is looking for adults who have serious open fractures or dislocations below the knee that need surgery. Participants will be randomly assigned to receive surgery within 72 hours or later, and their progress will be monitored over six months.
Are You a Good Fit for This Trial?
You may be able to join if
I am 18 years old or older.
I have a severe open fracture or dislocation below the knee that needs surgery.
My surgery will be done by a participating surgeon.
I can be enrolled in the trial within 48 hours of my injury.
You may not be able to join if
The site can't provide the accelerated flap treatment.
I am expected to have my limb amputated before the surgery.
I have critical limb ischemia that needs immediate treatment.
I have an infection at or near my injury.
I have burns where my injury is.
I am currently in jail.
I am expected to live less than a year.
I have a serious illness that means I won't live more than a year.
Summarized in plain language from this trial's official eligibility criteria.
The full criteria are further down this page — only the research team can
confirm whether you qualify.
Think this trial could be right for you?
Answer three quick questions written from this study's own rules to see if you may qualify. No account needed to find out.
The goal of this randomized controlled trial is to determine if accelerated flap coverage compared to standard flap coverage timing leads to improved infection-related complications in patients with open fractures and/or dislocations below the knee. Eligible patients will be randomized to receive either a flap within a goal of 72 hours of injury or standard of care flap timing for the institution.…
The goal of this randomized controlled trial is to determine if accelerated flap coverage compared to standard flap coverage timing leads to improved infection-related complications in patients with open fractures and/or dislocations below the knee. Eligible patients will be randomized to receive either a flap within a goal of 72 hours of injury or standard of care flap timing for the institution. The primary outcome will be a composite outcome to evaluate clinical status 6 months after randomization. Components of the composite outcome will be hierarchically assessed in the following order: 1) all-cause mortality, 2) amputation related to injury, 3) re-operation for infection and/or flap complication (flap compromise, partial and/or complete flap failure), and 4) days in hospital, defined as days in an acute in-patient hospital (i.e., not rehab or nursing facility).
This is the vanguard and international part of the FLAP ATTACK trial.
Trial Locations
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City
State
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Status
Eligibility Criteria
The inclusion criteria are:
1. Patients 18 years of age or older.
2. Severe lower extremity open fracture and/or dislocation below the knee requiring an acute flap for management of the musculoskeletal injury.
3. Will have all planned flap surgeries performed by a participating surgeon or delegate.…
The inclusion criteria are:
1. Patients 18 years of age or older.
2. Severe lower extremity open fracture and/or dislocation below the knee requiring an acute flap for management of the musculoskeletal injury.
3. Will have all planned flap surgeries performed by a participating surgeon or delegate.
4. Able to be randomized within 48 hours of injury.
The exclusion criteria are:
1. Site is unable to implement the accelerated flap protocol due to local logistics.
2. Primary amputation anticipated prior to attempted flap for management of the injury.
3. Critical limb ischemia that requires re-vascularization for limb perfusion.
4. Chronic or acute infection at or near the musculoskeletal injury site at the time of initial injury surgery.
5. Burns at the musculoskeletal injury site.
6. Incarceration.
7. Expected injury survival of less than 12 months.
8. Terminal illness with expected survival of less than 12 months.
9. Currently enrolled in a trial that does not permit co-enrollment.
10. Declined to provide informed consent.
11. Unable to obtain informed consent due to language barriers.
12. Unable to obtain informed consent because a legally authorized representative was unavailable.
13. Anticipated problems, in the judgment of research personnel, with maintaining follow-up with the patient.
14. Prior enrollment in the trial.
15. Eligible patient or LAR was not approached within screening window (missed participant).
16. Other reason to exclude the patient, as approved by the Principal Investigators.
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