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NCT Number: NCT06777511

Advancing Antimicrobial Photodynamic Therapy to Prevent Infection in Osseointegrated Prosthesis Patients

This will be a prospective observational trial enrolling 20 patients with osseointegrated prostheses. Participants will be recruited from the orthopaedic outpatient clinic at Walter Reed National Military Medical Center in Bethesda, MD.

All eligible consenting patients will undergo daily stoma management per standard of care.

Patients will integrate antimicrobial photodynamic therapy into their stoma management program. The first treatment will take place in the orthopaedic clinic. All others will take place at home. Topical 5-ALA will be applied to the metal at the penetration site. After 2 hours, the light delivery device will be utilized and light will be administered for 15 minutes.

Data collection: After obtaining informed consent, study personnel will record injury-specific variables, surgery-specific variables, other variables related to their hospital course, demographic variables as well as comorbidities on the study case report forms (CRFs). They will obtain this information directly from the participant, from the participant's medical record, and the participant's treating orthopaedic surgeon or other health care providers. Baseline data collection points include participant characteristics and amputation details such as age, sex, comorbidities, highest education level achieved, social support, initial reason for amputation, type of amputation and all surgical dates. Study participants will be followed at 1 and 2 weeks after initiation of PDT treatment. To ensure research participant safety, serious adverse events (SAEs) will be documented and promptly submitted to the local IRB as per the required reporting processes.

Follow-up: Study participants will be followed at 1 week and 2 weeks.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • All patients with osseointegrated prostheses 18 years of age or older

Exclusion criteria

  • Ongoing infection
  • Pregnant
  • Anticipated issues with compliance or follow-up

Treatment and study plan

5-aminolevulinic acid (5-ALA)

Drug

All patients who are recruited and enrolled into this study use topical 5- ALA, in combination with the light delivery device as part of their standard stoma management.

Photodynamic therapy (PDT)

Device

All patients who are recruited and enrolled into this study use topical 5- ALA, in combination with the light delivery device photodynamic therapy device as part of their standard stoma management.

Primary outcomes

  1. Feasibility

    Time frame: 2 weeks

    Feasibility will be defined as 80% of patients successfully completing the administration protocol as well as 1 week/2-week follow-up.

Secondary outcomes

  1. Treatment Evaluation Inventory-Short Form (TEI-SF)

    Time frame: 2 weeks

    The TEI-sf is a 9-item questionnaire used to measure intervention acceptability from the participants point of view. Scores range from 9 to 45, and scores above 27 are considered acceptable.

  2. System Usability Scale (SUS)

    Time frame: 2 weeks

    The SUS is a reliable 10-item usability measure with scores that range from 0 to 100 (an above average score is 68 or higher.

  3. Bioburden quantification (16S rRNA sequencing)

    Time frame: 2 weeks

    Bioburden will be quantified using quantitative PCR-based assays as well as addition of a "spikein" of a defined quantity of bacterial cells derived from halophilic organism Salnibacter ruber.

  4. Bioburden quantification (Optical Coherence Tomography (OCT)

    Time frame: 2 weeks

    Biofilm will be imaged and quantified on the metal abutment

  5. OCT "virtual biopsy"

    Time frame: 2 weeks

    Presence of inflammation, hypergranulation, and any resulting changes (e.g., the degree of epidermal regression, dermal attachment to the implant, and epithelial layer thickness) can be quantified through morphologic analysis of the OCT B-scans. Scars are characterized by excessive collagen deposition, increased blood vessel density, and parallel blood vessel organization compared with normal skin.

  6. Scar thickness

    Time frame: 2 weeks

    Scar thickness measured using OCT

  7. Blood vessel density

    Time frame: 2 weeks

    Blood vessel density measuring using OCT

  8. Presence of hypergranulation

    Time frame: 2 weeks

    Hypergranulation measured using OCT

  9. Pain during light exposure

    Time frame: 2 weeks

    Patient reported pain during light exposure

  10. Discomfort, burning, itchiness, or redness

    Time frame: 2 weeks

    Patient reported discomfort, burning, itchiness or redness

Study contacts

Contact information is provided by the study sponsor or research team.

Devin Mullin

CONTACT

[email protected]

603-650-6032

Ida Gitajn

CONTACT

[email protected]

603-650-6032

Sponsors and collaborators

Lead sponsor

Dartmouth-Hitchcock Medical Center

Other

Collaborators

  • Walter Reed Army Medical Center

Registry information

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Jan 16, 2025
Registry last updated
Feb 4, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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