Clinical trial NCT02704104: 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
Overall status: COMPLETED
Phase: NA
Conditions: Skin Neoplasms
Keywords: topical hemostat
self-assembling peptide barrier
Lead sponsor: Arch Therapeutics
Sponsor class: INDUSTRY
First posted: 2016-03-09
Enrollment: 46
Sex: ALL
Minimum age (years): 18
Maximum age (years): 85
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SUPPORTIVE_CARE

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

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investigation-related procedure not part of standard medical care, and with the understanding that consent may be withdrawn at any time without prejudice to future medical care.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

Primary outcomes:
measure: Number of Participants With Treatment-emergent Adverse Events Related to Clinical Investigation Product During the 30 Days of Follow-up
timeFrame: 30 Days Post Procedure
Secondary outcomes:
measure: Median Time to Hemostasis (Seconds)
timeFrame: At time of application (Day 0)
measure: Time to Hemostasis in Seconds Per Square Centimeter Wound Area
timeFrame: At time of application (Day 0)
measure: Number of Wounds With ASEPSIS Wound Scores of 0 at Day 7 and Day 30
timeFrame: 7 and 30 Days Post Procedure
Other outcomes:
measure: Time to Hemostasis in Patients Who Were Taking or Not Taking Anti Platelet Medication
timeFrame: Day 0
Locations:
city: Galway
country: Ireland
facility: University College Hospital
Study officials:
affiliation: Professor of Surgery
name: Jack Kelly, MD
role: PRINCIPAL_INVESTIGATOR
References:
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.