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

NCT03820713 | Completed

• 2 other identifiers: AOS-CL1000-02CL-PL-057-01
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 2

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.

Conditions

Reduction of Postoperative Adhesions

Outcome Measures

Primary Outcomes (5)

• 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).

  Within 30 days from the first surgery

• 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).

  Until the second surgery but not longer than 7 months

• 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.

  Through study completion, an average of 1 year

• 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

  Through study completion, an average of 1 year

• 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

  Through study completion, an average of 1 year

Secondary Outcomes (2)

• Incidence of general surgical complications; incidence of minor adverse events

  Until the second surgery but not longer than 7 months

• Usability of the device Instructions for Use (questionnaire)

  Through study completion, an average of 1 year

Study Arms (2)

Investigational arm

EXPERIMENTAL

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.

Procedure: Concentrate of plasma coagulation factors

Control arm

PLACEBO COMPARATOR

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

Procedure: 0.9% saline

Interventions

Concentrate of plasma coagulation factors PROCEDURE

The plasma concentrate of coagulation factors is applied to the surgical site.

Investigational arm

0.9% saline PROCEDURE

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

Control arm

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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
• 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.)

You may not qualify if:

• 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
• 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.

Sponsors & Collaborators

• Eio Biomedical Ltd.: lead

Study Sites (2)

Kaunas Clinical Hospital

Kaunas, LT-47144, Lithuania

Location

Hospital of Lithuanian University of Health Sciences Kauno Klinikos

Kaunas, LT-50009, Lithuania

Location

MeSH Terms

Interventions

Saline Solution

Intervention Hierarchy (Ancestors)

Crystalloid Solutions; Isotonic Solutions; Solutions; Pharmaceutical Preparations

Study Officials

• Rafael Miller, MD

  EIO Biomedical Ltd., Medical Adviser

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Model Details: Prospective, randomized, double blinded, parallel, controlled, two-arm, two-center

Study Record Dates

• First Submitted: August 12, 2018
• First Posted: January 29, 2019
• Study Start: May 9, 2018
• Primary Completion: July 15, 2020
• Study Completion: July 15, 2020
• Last Updated: July 23, 2020

Record last verified: 2020-07

Locations

LI (2)