Evaluation of the Feasibility, Safety, Initial Efficacy and Clinical Usability of FuseX Anti-Adhesion System
Reduction of Postoperative Adhesions
About this trial
This is an interventional prevention trial for Reduction of Postoperative Adhesions
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).
Sites / Locations
- Kaunas Clinical Hospital
- Hospital of Lithuanian University of Health Sciences Kauno Klinikos
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Investigational arm
Control arm
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.