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Evaluation of the Feasibility, Safety, Initial Efficacy and Clinical Usability of FuseX Anti-Adhesion System

Primary Purpose

Reduction of Postoperative Adhesions

Status
Completed
Phase
Not Applicable
Locations
Lithuania
Study Type
Interventional
Intervention
Concentrate of plasma coagulation factors
0.9% saline
Sponsored by
Eio Biomedical Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Reduction of Postoperative Adhesions

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion criteria

PREOPERATIVE INCLUSION

Preoperatively the patient must:

  1. Understand and be able to follow the requirements of the protocol including signing and dating an Ethics Committee approved Informed Consent prior to undergoing any protocol related procedures
  2. Patients undergoing any of the above procedures
  3. Male or female subjects > 18 years of age
  4. Subjects for whom a second abdominal surgery is planned within less than 12 months of the first surgical procedure
  5. BMI<40

INTRAOPERATIVE INCLUSION

During surgery the patient must require having one of the following surgeries performed on their person:

  1. Planned or emergency colonic resection surgery with temporary stoma creation due to colonic perforation, acute diverticulitis or colonic obstruction.
  2. Surgery for low rectal cancer - low anterior resection. This surgery includes resection of lower part of rectum, colo-anal anastomosis and protective ileostomy creation. Usually patient undergo second stage procedure closure of ileostomy in 1-3 months.
  3. Total proctocolectomy and a pelvic pouch with diverting ileostomy in cases of surgery for Ulcerative colitis. In this kind of surgery there is the intention to close the temporary ileostomy in 1-3 months.
  4. Creation of stoma due to infectious process or trauma in the peritoneum (such as Fournier gangrene, laceration of rectum, etc.)

Exclusion Criteria

PREOPERATIVE EXCLUSION

Preoperatively a patient must not:

  1. be unable to give their own written informed consent,
  2. be currently enrolled in another clinical study with drug or device related to adhesions or has participated in such a study within the last 30 days,
  3. have received or is expected to receive any other investigational product or technique belonging to the group of hemostats, adhesion reduction devices or other products, meshes, or other types of implants in the abdominal cavity within 30 days prior to or during enrolment,
  4. subjects who have received or will receive (approximately within the next eight months) abdominal/pelvic irradiation for reasons other than rectal carcinoma.
  5. BMI≥40
  6. Subjects who have received selective factor Xa inhibitors and/or direct thrombin inhibitors within 24 hours prior to surgery.
  7. Patients taking immune system suppressants deemed by the surgeon to interfere with wound healing, Patients taking daily doses of corticosteroids exceeding 20mg within the prior 30 days are to be excluded. Patients requiring perioperative corticosteroid supplementation are not to be excluded.
  8. Patients with a known history of severe multiple drug allergies
  9. Patients who have a life expectancy of less than 6 months because of a medical condition or disease state
  10. Any patient with a medical condition or other serious condition which will interfere with compliance and/or ability to complete this study protocol or who in the opinion of the investigator would not be a good candidate for enrollment

INTRAOPERATIVE EXCLUSION

  1. Patients for whom it is known, prior to the initial procedure, that loop ileostomy or colostomy closure is not feasible for any reason
  2. Patients with peritoneal carcinomatosis
  3. Patients with endometriosis
  4. Use of hernia mesh in the first surgery.
  5. Subjects treated with hemostatic agents in which the sealant remains in the patient's body (e.g. Fibrin sealant).

Sites / Locations

  • Kaunas Clinical Hospital
  • Hospital of Lithuanian University of Health Sciences Kauno Klinikos

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Investigational arm

Control arm

Arm Description

Treatment group receives a concentrate of coagulation factors. The device concentrates coagulation factors from donor plasma; the concentrate is applied to the surgical site intended to reduce the incidence, extent and severity of postoperative adhesions.

Control group receives an identical syringe and applicator generated by processing normal saline 0.9% instead of plasma.

Outcomes

Primary Outcome Measures

Treatment-emergent adverse event incidence
Incidence of adverse events related to treatment requiring any invasive procedure in the test group (who used blood plasma concentrate prepared using FuseX Anti-Adhesion System) compared to control group (who used normal saline processed by the same FuseX Anti-Adhesion System).
Overall adverse event incidence
Overall adverse event incidence will be evaluated by the presence and severity of adverse events and serious adverse events in the test group (who used blood plasma concentrate prepared using FuseX Anti-Adhesion System) vs. control group (who used normal saline processed by the same FuseX Anti-Adhesion System).
Severity of new formed adhesions in the target region
Severity of new formed adhesions having its source in the target region will be assessed by a blinded surgeon during the second surgery by grading the adhesion severity for each region on a scale from 0 (no adhesions) to 3 (strong vascularized adhesions that require sharp dissection and cannot be separated without tissue damage). The peritoneal cavity will be divided into 9 separate scoring regions. A peritoneal adhesion index (PAI) (sum of scores for all the regions) will be calculated per each patient.
Usability as assessed by Surgeon questionnaire
a. Ease of application will be scored on a 5-point Likert scale (1 = very hard to 5 = very easy). b. Percentage of coverage the entire defined surgical field. c. mL of the materials used
Usability as assessed by Operator questionnaire
a. Ease of device use will be scored on a 5-point Likert scale (1 = very hard to 5 = very easy). b. Device operation time

Secondary Outcome Measures

Incidence of general surgical complications; incidence of minor adverse events
Incidence of general surgical complications including but not limited to: Septic shock, cardiovascular events, respiratory tract infections and pulmonary atelectasis, urinary tract infections, thromboembolic events Superficial Surgical Site Infections (SSI) - soft tissue infection, cellulitis, incisional abscess, wound dehiscence Deep SSI - abdominal abscess, pelvic abscess, peritonitis. Incidence of minor adverse events such as nausea, vomiting, abdominal pain, ileus, allergic reactions
Usability of the device Instructions for Use (questionnaire)
Usability of the device user manual will be scored on a 5-point Likert scale (1 = very hard to 5 = very easy).

Full Information

First Posted
August 12, 2018
Last Updated
July 22, 2020
Sponsor
Eio Biomedical Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03820713
Brief Title
Evaluation of the Feasibility, Safety, Initial Efficacy and Clinical Usability of FuseX Anti-Adhesion System
Official Title
Prospective, Randomized, Double Blinded, Parallel, Controlled, Two-arm, Two-center Evaluation of the Feasibility, Safety, Initial Efficacy and Clinical Usability of FuseX Anti-Adhesion System
Study Type
Interventional

2. Study Status

Record Verification Date
July 2020
Overall Recruitment Status
Completed
Study Start Date
May 9, 2018 (Actual)
Primary Completion Date
July 15, 2020 (Actual)
Study Completion Date
July 15, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Eio Biomedical Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
Evaluation of the feasibility, safety, initial efficacy and usability of FuseX Anti-Adhesion system toward further studies that will be powered to proved its safety and efficacy. In addition, this initial study will serve to yield blood bank and surgeon feedback towards improving the system.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Reduction of Postoperative Adhesions

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Prospective, randomized, double blinded, parallel, controlled, two-arm, two-center
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Investigational arm
Arm Type
Experimental
Arm Description
Treatment group receives a concentrate of coagulation factors. The device concentrates coagulation factors from donor plasma; the concentrate is applied to the surgical site intended to reduce the incidence, extent and severity of postoperative adhesions.
Arm Title
Control arm
Arm Type
Placebo Comparator
Arm Description
Control group receives an identical syringe and applicator generated by processing normal saline 0.9% instead of plasma.
Intervention Type
Procedure
Intervention Name(s)
Concentrate of plasma coagulation factors
Intervention Description
The plasma concentrate of coagulation factors is applied to the surgical site.
Intervention Type
Procedure
Intervention Name(s)
0.9% saline
Intervention Description
Control group receives an identical syringe and applicator generated by processing normal saline 0.9% instead of plasma.
Primary Outcome Measure Information:
Title
Treatment-emergent adverse event incidence
Description
Incidence of adverse events related to treatment requiring any invasive procedure in the test group (who used blood plasma concentrate prepared using FuseX Anti-Adhesion System) compared to control group (who used normal saline processed by the same FuseX Anti-Adhesion System).
Time Frame
Within 30 days from the first surgery
Title
Overall adverse event incidence
Description
Overall adverse event incidence will be evaluated by the presence and severity of adverse events and serious adverse events in the test group (who used blood plasma concentrate prepared using FuseX Anti-Adhesion System) vs. control group (who used normal saline processed by the same FuseX Anti-Adhesion System).
Time Frame
Until the second surgery but not longer than 7 months
Title
Severity of new formed adhesions in the target region
Description
Severity of new formed adhesions having its source in the target region will be assessed by a blinded surgeon during the second surgery by grading the adhesion severity for each region on a scale from 0 (no adhesions) to 3 (strong vascularized adhesions that require sharp dissection and cannot be separated without tissue damage). The peritoneal cavity will be divided into 9 separate scoring regions. A peritoneal adhesion index (PAI) (sum of scores for all the regions) will be calculated per each patient.
Time Frame
Through study completion, an average of 1 year
Title
Usability as assessed by Surgeon questionnaire
Description
a. Ease of application will be scored on a 5-point Likert scale (1 = very hard to 5 = very easy). b. Percentage of coverage the entire defined surgical field. c. mL of the materials used
Time Frame
Through study completion, an average of 1 year
Title
Usability as assessed by Operator questionnaire
Description
a. Ease of device use will be scored on a 5-point Likert scale (1 = very hard to 5 = very easy). b. Device operation time
Time Frame
Through study completion, an average of 1 year
Secondary Outcome Measure Information:
Title
Incidence of general surgical complications; incidence of minor adverse events
Description
Incidence of general surgical complications including but not limited to: Septic shock, cardiovascular events, respiratory tract infections and pulmonary atelectasis, urinary tract infections, thromboembolic events Superficial Surgical Site Infections (SSI) - soft tissue infection, cellulitis, incisional abscess, wound dehiscence Deep SSI - abdominal abscess, pelvic abscess, peritonitis. Incidence of minor adverse events such as nausea, vomiting, abdominal pain, ileus, allergic reactions
Time Frame
Until the second surgery but not longer than 7 months
Title
Usability of the device Instructions for Use (questionnaire)
Description
Usability of the device user manual will be scored on a 5-point Likert scale (1 = very hard to 5 = very easy).
Time Frame
Through study completion, an average of 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria PREOPERATIVE INCLUSION Preoperatively the patient must: Understand and be able to follow the requirements of the protocol including signing and dating an Ethics Committee approved Informed Consent prior to undergoing any protocol related procedures Patients undergoing any of the above procedures Male or female subjects > 18 years of age Subjects for whom a second abdominal surgery is planned within less than 12 months of the first surgical procedure BMI<40 INTRAOPERATIVE INCLUSION During surgery the patient must require having one of the following surgeries performed on their person: Planned or emergency colonic resection surgery with temporary stoma creation due to colonic perforation, acute diverticulitis or colonic obstruction. Surgery for low rectal cancer - low anterior resection. This surgery includes resection of lower part of rectum, colo-anal anastomosis and protective ileostomy creation. Usually patient undergo second stage procedure closure of ileostomy in 1-3 months. Total proctocolectomy and a pelvic pouch with diverting ileostomy in cases of surgery for Ulcerative colitis. In this kind of surgery there is the intention to close the temporary ileostomy in 1-3 months. Creation of stoma due to infectious process or trauma in the peritoneum (such as Fournier gangrene, laceration of rectum, etc.) Exclusion Criteria PREOPERATIVE EXCLUSION Preoperatively a patient must not: be unable to give their own written informed consent, be currently enrolled in another clinical study with drug or device related to adhesions or has participated in such a study within the last 30 days, have received or is expected to receive any other investigational product or technique belonging to the group of hemostats, adhesion reduction devices or other products, meshes, or other types of implants in the abdominal cavity within 30 days prior to or during enrolment, subjects who have received or will receive (approximately within the next eight months) abdominal/pelvic irradiation for reasons other than rectal carcinoma. BMI≥40 Subjects who have received selective factor Xa inhibitors and/or direct thrombin inhibitors within 24 hours prior to surgery. Patients taking immune system suppressants deemed by the surgeon to interfere with wound healing, Patients taking daily doses of corticosteroids exceeding 20mg within the prior 30 days are to be excluded. Patients requiring perioperative corticosteroid supplementation are not to be excluded. Patients with a known history of severe multiple drug allergies Patients who have a life expectancy of less than 6 months because of a medical condition or disease state Any patient with a medical condition or other serious condition which will interfere with compliance and/or ability to complete this study protocol or who in the opinion of the investigator would not be a good candidate for enrollment INTRAOPERATIVE EXCLUSION Patients for whom it is known, prior to the initial procedure, that loop ileostomy or colostomy closure is not feasible for any reason Patients with peritoneal carcinomatosis Patients with endometriosis Use of hernia mesh in the first surgery. Subjects treated with hemostatic agents in which the sealant remains in the patient's body (e.g. Fibrin sealant).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Rafael Miller, MD
Organizational Affiliation
EIO Biomedical Ltd., Medical Adviser
Official's Role
Principal Investigator
Facility Information:
Facility Name
Kaunas Clinical Hospital
City
Kaunas
ZIP/Postal Code
LT-47144
Country
Lithuania
Facility Name
Hospital of Lithuanian University of Health Sciences Kauno Klinikos
City
Kaunas
ZIP/Postal Code
LT-50009
Country
Lithuania

12. IPD Sharing Statement

Learn more about this trial

Evaluation of the Feasibility, Safety, Initial Efficacy and Clinical Usability of FuseX Anti-Adhesion System

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