Prevention and/or Reduction of Hemorrhoids and/or Thrombosed External Hemorrhoids Using the HEM-AVERT Perianal Stabilizer Instrument
Condition: Hemorrhoids
MeSH terms: Hemorrhoids
Study type: Interventional
Phase: Phase 1

Summary: 
      This study is being conducted to evaluate an investigational instrument called the HEM-AVERT
      Perianal Stabilizer and its efficacy in reducing the occurrence or severity of hemorrhoids
      and thrombosed external hemorrhoids (TEH) which commonly occur during vaginal delivery.
    

Detailed description: 
      This study is being conducted to evaluate an investigational instrument called the HEM-AVERT™
      Perianal Stabilizer and its efficacy in reducing the occurrence or severity of hemorrhoids
      and thrombosed external hemorrhoids (TEH). Hemorrhoids and TEH are caused by blood pooling in
      a distended vein and forming a clot, or thrombose, in the outer region of the anus. An anal
      fissure is a small split or tear in the anal mucosa that may result in painful bowel
      movements and bleeding. Like hemorrhoids, anal fissures are common in women after childbirth.
      Lacerations are graded as first, second, third and fourth degree. First and second degree are
      perineal lacerations and involve the mucosa and perineum and usually heal by themselves.
      First and second degree lacerations are considered to be a normal occurrence in child birth.
      Third degree lacerations involve the anal sphincter and fourth degree lacerations involve the
      sphincter and mucosa of the anus with bowel involvement and usually require surgical repair.
      Per the product classification that was assigned to this instrument by the FDA, the
      instrument is both non-invasive and posses a non-significant risk. It is classified as a
      manual, general instrument with no specific indications, but has a general indication of
      stabilizing pressure. The purpose of this clinical study is to collect data to support a
      510(k) application to obtain the specific indication of preventing the occurrence of
      hemorrhoids, or reducing the severity of hemorrhoids which often occur during vaginal
      deliveries. Hemorrhoids and TEH represent common adverse events in vaginal births with
      reported occurrences ranging from a low of 9% to a high of 34% in the reported literature.
      Currently no preventative treatment exists. There will be two study groups; an
      investigational group (subjects receiving the HEM-AVERT™ instrument) and the control group
      (subjects will not receive the HEM-AVERT™ instrument). The HEM-AVERT™ Perianal Stabilizer is
      a Class 1, exempt device in accordance with FDA regulation 21 CFR 890.5765. The HEM-AVERT™ is
      a non-invasive instrument used to provide continuous pressure to the perianal region as a
      means to help provide support during the labor process. Each HEM-AVERT™ instrument is a
      single use, disposable, sterile, individually packaged instrument. The HEM-AVERT™ instrument
      consists of three components: 1) a rigid polymer base manufactured from a medical grade
      polycarbonate; 2) a centrally located cushioning pad which is composed of a laminate of
      medical grade polyester non-woven tape and medical grade polyethylene foam tape; and 3) two
      lateral hook and loop fastener adhesive strips (with liners) ("loop" strips that attach to
      the mating "hook" [similar to VELCRO®]) which is used to provide the tension needed to keep
      the instrument firmly in place during delivery. The cushioning pad and adhesive strips are
      manufactured using materials commonly found in medical instruments and used in medical
      procedures. All of the materials used to manufacture this instrument meet the available
      national or international standards specifications as applied to this instrument. This
      instrument is not to be implanted.
    

Intervention name(s): Hem-Avert Perianal Stabilizer
Intervention type(s): Device
Intervention description(s): Hem-Avert Perianal Stabilizer, TNP-01L, single-use, disposable, sterile, individually packaged instrument
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Hemorrhoids; Thrombosed External Hemorrhoids (TEH); Reduction; Prevention; Stabilizer Device; Pregnant; Vaginal Birth; Single Birth; Asymptomatic Hemorrhoids