A Comparative Study of the Healing of Chronic Ulcers of Recessive Epidermolysis Bullosa : Dressing vs Amniotic Membrane

Study Overview
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Brief Summary
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Skin wounds of Recessive Epidermolysis Bullosa Dystrophica (REBD) involve pain, superinfection, protein-losing, inflammation, and joint contractures are the bed of squamous cell carcinoma. There is no precise data on the kinetics of healing post-bullous erosions but clinical experience suggests that most epidermise in less than a month. Some, however, for unknown reasons, persist for several months. These chronic ulcers (UC), arbitrarily defined for this study as lasting more than three months are a source of major discomfort and could play a decisive role in the morbidity and mortality of the disease. The aim of this study is to evaluate the efficacy of the amniotic membrane on the healing of chronic ulcers REBD on the percentage ulcerated surface re-epithelialised at 12 weeks (M3) from the start of treatment.

Official Title
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A Comparative Study of the Healing of Chronic Skin Ulcers of Recessive Dystrophic Epidermolysis Bullosa : Standard Dressing Versus Amniotic Membrane.

Conditions
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Epidermolysis Bullosa Dystrophica, Recessive, Ulcer

Intervention / Treatment
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* Device: Amniotic Membrane


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age between 2 years and 60 REBD clinically evident with immunohistological confirmation and / or genetic REBD with at least two chronic ulcers (> 3 months) comparable Signing the informed consent of the patient and / or (children) of parents holding parental authority Affiliation to a social security scheme (beneficiary or legal) Exclusion Criteria: Epidermoid carcinoma on the target or chronic ulcers Budding excessive requiring the application of a topical corticosteroid on the target or chronic ulcers Skin bacterial superinfection clinically overt requiring oral antibiotics Herpes simplex virus superinfection major evolutionary and malnutrition defined as a BMI <12 or more than 2 variant between screening and randomization OR a serum albumin <20 g / l or more ranging from 5 g / l between screening and randomization major and progressive anemia defined by a Hb <6 g / liter or variant more than 4 g / l between screening and randomization Life expectancy estimated at less than 3 months Pregnancy Inability to understand or observance of the rules of protocol Participation in another interventional therapeutic biomedical research whose treatment is not yet completed or the primary endpoint is not yet measured at the time of inclusion in Mabul

Ages Eligible for Study
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Minimum Age: 2 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Standard Dressing<br>J0 to J42 : once a week, primary dressing with Mepitel® | Device: Amniotic Membrane<br> <br> |
| Experimental: Amniotic Membrane<br>J0 to J42: once a week, Mepitel® and amniotic membrane (one or several depending on the graft size, so that the ulcer was completely covered with MAH). The last amniotic membrane is left in place. | Device: Amniotic Membrane<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of ulcerated area re-epithelialised |  | at 12 weeks from the start of treatment |