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Safety and Performance Evaluation of the Topical Hemostatic Device (AC5™) Following Excision of Skin Lesions

Primary Purpose

Skin Neoplasms

Status
Completed
Phase
Not Applicable
Locations
Ireland
Study Type
Interventional
Intervention
AC5 Topical Hemostatic Device
Sponsored by
Arch Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Skin Neoplasms focused on measuring topical hemostat, self-assembling peptide barrier

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Men and women between the ages of 18 and 85.
  • Voluntary written informed consent, given before performance of any clinical investigation-related procedure not part of standard medical care, and with the understanding that consent may be withdrawn at any time without prejudice to future medical care.
  • Scheduled for excision of 2 (two) or more skin lesions from their trunk or upper limbs (defined as lying below the level of the inferior border of the patient's mandible).
  • If subjects is currently prescribed an antiplatelet therapy, it must from one of the following therapies at levels as per hospital protocol:
  • Antiplatelet monotherapy with one of the following agents:

    • Aspirin
    • Clopidogrel (thienopyridine-class antiplatelet agent)
    • Ticagrelor
    • Dipyridamole
  • Female subjects must meet at least one of the following additional criteria:

    • Surgically sterile with bilateral tubal ligation or hysterectomy.
    • Post-menopausal for at least one year.
    • If of child-bearing potential, practicing an acceptable method of birth control for the duration of the clinical investigation as judged by the Investigator, such as condoms, foams, jellies, diaphragm, intrauterine device or abstinence.
  • Subjects willing to undergo pre-and post-clinical investigation blood and urine collection, physical exams and laboratory investigations.

Exclusion Criteria:

  • Active infection as demonstrated by temperature > 37.5 C and clinical features of active infection.
  • Wound expected to expose bone or tendon.
  • Wound expected to require topical antibiotics.
  • Know contraindication or reaction to Tegaderm use.
  • Presence of malignancy or clinical expectation of malignancy based on examination.
  • Known immunosuppression or taking immunosuppressive agents including systemic steroids.
  • Plan for adjunctive flap or graft procedure to obtain closure of the wound(s) subject to this study.
  • History of severe co-morbidity with expected patient survival ≤ 6 months.
  • Pregnancy or lactation
  • Intake of investigational drugs within 28 days prior to enrollment.
  • Currently taking oral anticoagulants
  • History of concurrent condition that, in the Investigator's opinion, would jeopardize the safety of the subject or compliance with the protocol.
  • History of clinically significant, active disease (within 12 months prior to enrollment) of the pulmonary, gastrointestinal, neurological, genitourinary, renal, or haematological system, that in the opinion of the Principal Investigator, may confound the results of the trial or pose additional risk to the subject following the administration of AC5.
  • History of clinically significant cardiac disorder, defined as: acute coronary syndrome, congestive heart failure (NYHA class III/IV), diagnosis of unstable angina pectoris, cerebral stroke and or myocardial infarction within the last 12 months or planned coronary or carotid revascularisation procedures anytime through 30 Day follow-up.
  • History of severe uncontrolled treated or untreated hypertension (systolic blood pressure ≥180 mmHg or diastolic blood pressure ≥100 mmHg).
  • Likely inability to comply with the protocol or cooperate fully with the investigator and site personnel.
  • Presence of significant cognitive impairment (Mini Mental Status Examination <22) or mental incapacity.
  • Unwillingness or language barrier precluding adequate understanding of the trial procedure or cooperation with trial site personnel.
  • Known or suspected active abuse of alcohol, narcotics or non-prescription drugs.
  • Other planned surgical procedures within 30 days prior to or 30 days post-index procedure.
  • Prior enrollment in this AC5 clinical trial

Sites / Locations

  • University College Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

AC5 Topical Hemostatic Device

Control

Arm Description

The intervention in this arm is the application of a topical hemostatic agent (AC5) to a freshly excised skin lesion

The intervention in this arm is the application of saline (Control) to a freshly excised skin lesion

Outcomes

Primary Outcome Measures

Number of Participants With Treatment-emergent Adverse Events Related to Clinical Investigation Product During the 30 Days of Follow-up
Local reactions to clinical investigation product (pain, edema, rash, cellulitis, localized infectious processes, other) detected during clinical investigation follow up. Systemic reactions after administration of clinical investigation product (fever, allergic reaction, anaphylaxis or any clinical untoward event) detected during clinical investigation follow up.

Secondary Outcome Measures

Median Time to Hemostasis (Seconds)
Measure of time from application of treatment or control to the wound, to bleeding cessation
Time to Hemostasis in Seconds Per Square Centimeter Wound Area
Measure of time from application of treatment or control to the wound, to bleeding cessation/ divided by wound area
Number of Wounds With ASEPSIS Wound Scores of 0 at Day 7 and Day 30
The Additional treatment, the presence of Serous discharge, Erythema, Purulent exudate, and Separation of the deep tissues, the Isolation of bacteria, and the duration of inpatient Stay longer than 14 days (ASEPSIS) Wound Score (reference 1) was used to assess wound healing and overall wound sepsis. This multipoint system is reported as a total score ranging from 0 to 30 points in the first 7 days postoperatively. Additional points after 7 days can be added for additional treatments such as use of antibiotics, drainage of pus under local anesthesia, and debridement of the wound; and isolation of bacteria or duration of stay, for a total score of from 0 to 70 points by day 30. Total scores from 0-10 indicate satisfactory healing, from 11 to 20=disturbance of healing, from 21 to 30=minor wound infection, from 31 to 40=moderate wound infection, and >40 points signifies severe infection. For this study, the number of wounds with ASEPSIS score = 0 was counted.

Full Information

First Posted
March 1, 2016
Last Updated
August 6, 2018
Sponsor
Arch Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT02704104
Brief Title
Safety and Performance Evaluation of the Topical Hemostatic Device (AC5™) Following Excision of Skin Lesions
Official Title
A Randomized Controlled Single-Blind Investigation to Evaluate the Safety and Performance of the AC5 Topical Hemostatic Device (AC5™) Following Excision of Skin Lesions
Study Type
Interventional

2. Study Status

Record Verification Date
August 2018
Overall Recruitment Status
Completed
Study Start Date
February 2016 (undefined)
Primary Completion Date
June 2016 (Actual)
Study Completion Date
June 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Arch Therapeutics

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study is designed to monitor patient safety after excision of skin lesions and subsequent application of AC5 topical hemostatic agent and to assess the performance of AC5 for controlling bleeding in skin wounds.
Detailed Description
This is a randomized, controlled single-blind pilot study to evaluate the safety and performance of AC5 following excision of lesions from the trunk or upper limbs under local anesthetic, in patients currently prescribed or not prescribed antiplatelet monotherapy. Each patient had sequential shave excision of two lesions (one treatment, one Control) at the same sitting. The sequence of wound treatment (AC5 first or Control first) was randomized. Study and Control treatments were administered immediately after lesion excision, followed by determination of time to hemostasis (TTH), and application of an occlusive water-resistant dressing

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Skin Neoplasms
Keywords
topical hemostat, self-assembling peptide barrier

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Investigator
Allocation
Randomized
Enrollment
46 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AC5 Topical Hemostatic Device
Arm Type
Experimental
Arm Description
The intervention in this arm is the application of a topical hemostatic agent (AC5) to a freshly excised skin lesion
Arm Title
Control
Arm Type
Placebo Comparator
Arm Description
The intervention in this arm is the application of saline (Control) to a freshly excised skin lesion
Intervention Type
Device
Intervention Name(s)
AC5 Topical Hemostatic Device
Intervention Description
Randomized application of the hemostatic agent AC5 to one of two freshly excised lesions in each patient
Primary Outcome Measure Information:
Title
Number of Participants With Treatment-emergent Adverse Events Related to Clinical Investigation Product During the 30 Days of Follow-up
Description
Local reactions to clinical investigation product (pain, edema, rash, cellulitis, localized infectious processes, other) detected during clinical investigation follow up. Systemic reactions after administration of clinical investigation product (fever, allergic reaction, anaphylaxis or any clinical untoward event) detected during clinical investigation follow up.
Time Frame
30 Days Post Procedure
Secondary Outcome Measure Information:
Title
Median Time to Hemostasis (Seconds)
Description
Measure of time from application of treatment or control to the wound, to bleeding cessation
Time Frame
At time of application (Day 0)
Title
Time to Hemostasis in Seconds Per Square Centimeter Wound Area
Description
Measure of time from application of treatment or control to the wound, to bleeding cessation/ divided by wound area
Time Frame
At time of application (Day 0)
Title
Number of Wounds With ASEPSIS Wound Scores of 0 at Day 7 and Day 30
Description
The Additional treatment, the presence of Serous discharge, Erythema, Purulent exudate, and Separation of the deep tissues, the Isolation of bacteria, and the duration of inpatient Stay longer than 14 days (ASEPSIS) Wound Score (reference 1) was used to assess wound healing and overall wound sepsis. This multipoint system is reported as a total score ranging from 0 to 30 points in the first 7 days postoperatively. Additional points after 7 days can be added for additional treatments such as use of antibiotics, drainage of pus under local anesthesia, and debridement of the wound; and isolation of bacteria or duration of stay, for a total score of from 0 to 70 points by day 30. Total scores from 0-10 indicate satisfactory healing, from 11 to 20=disturbance of healing, from 21 to 30=minor wound infection, from 31 to 40=moderate wound infection, and >40 points signifies severe infection. For this study, the number of wounds with ASEPSIS score = 0 was counted.
Time Frame
7 and 30 Days Post Procedure
Other Pre-specified Outcome Measures:
Title
Time to Hemostasis in Patients Who Were Taking or Not Taking Anti Platelet Medication
Time Frame
Day 0

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Men and women between the ages of 18 and 85. Voluntary written informed consent, given before performance of any clinical investigation-related procedure not part of standard medical care, and with the understanding that consent may be withdrawn at any time without prejudice to future medical care. Scheduled for excision of 2 (two) or more skin lesions from their trunk or upper limbs (defined as lying below the level of the inferior border of the patient's mandible). If subjects is currently prescribed an antiplatelet therapy, it must from one of the following therapies at levels as per hospital protocol: Antiplatelet monotherapy with one of the following agents: Aspirin Clopidogrel (thienopyridine-class antiplatelet agent) Ticagrelor Dipyridamole Female subjects must meet at least one of the following additional criteria: Surgically sterile with bilateral tubal ligation or hysterectomy. Post-menopausal for at least one year. If of child-bearing potential, practicing an acceptable method of birth control for the duration of the clinical investigation as judged by the Investigator, such as condoms, foams, jellies, diaphragm, intrauterine device or abstinence. Subjects willing to undergo pre-and post-clinical investigation blood and urine collection, physical exams and laboratory investigations. Exclusion Criteria: Active infection as demonstrated by temperature > 37.5 C and clinical features of active infection. Wound expected to expose bone or tendon. Wound expected to require topical antibiotics. Know contraindication or reaction to Tegaderm use. Presence of malignancy or clinical expectation of malignancy based on examination. Known immunosuppression or taking immunosuppressive agents including systemic steroids. Plan for adjunctive flap or graft procedure to obtain closure of the wound(s) subject to this study. History of severe co-morbidity with expected patient survival ≤ 6 months. Pregnancy or lactation Intake of investigational drugs within 28 days prior to enrollment. Currently taking oral anticoagulants History of concurrent condition that, in the Investigator's opinion, would jeopardize the safety of the subject or compliance with the protocol. History of clinically significant, active disease (within 12 months prior to enrollment) of the pulmonary, gastrointestinal, neurological, genitourinary, renal, or haematological system, that in the opinion of the Principal Investigator, may confound the results of the trial or pose additional risk to the subject following the administration of AC5. History of clinically significant cardiac disorder, defined as: acute coronary syndrome, congestive heart failure (NYHA class III/IV), diagnosis of unstable angina pectoris, cerebral stroke and or myocardial infarction within the last 12 months or planned coronary or carotid revascularisation procedures anytime through 30 Day follow-up. History of severe uncontrolled treated or untreated hypertension (systolic blood pressure ≥180 mmHg or diastolic blood pressure ≥100 mmHg). Likely inability to comply with the protocol or cooperate fully with the investigator and site personnel. Presence of significant cognitive impairment (Mini Mental Status Examination <22) or mental incapacity. Unwillingness or language barrier precluding adequate understanding of the trial procedure or cooperation with trial site personnel. Known or suspected active abuse of alcohol, narcotics or non-prescription drugs. Other planned surgical procedures within 30 days prior to or 30 days post-index procedure. Prior enrollment in this AC5 clinical trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jack Kelly, MD
Organizational Affiliation
Professor of Surgery
Official's Role
Principal Investigator
Facility Information:
Facility Name
University College Hospital
City
Galway
Country
Ireland

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
2868173
Citation
Wilson AP, Treasure T, Sturridge MF, Gruneberg RN. A scoring method (ASEPSIS) for postoperative wound infections for use in clinical trials of antibiotic prophylaxis. Lancet. 1986 Feb 8;1(8476):311-3. doi: 10.1016/s0140-6736(86)90838-x.
Results Reference
result

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Safety and Performance Evaluation of the Topical Hemostatic Device (AC5™) Following Excision of Skin Lesions

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