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The objective of this clinical study is to evaluate healing of incisions made with the PEAK PlasmaBlade 4.0 compared to scalpel and traditional electrosurgery (Bovie); to monitor and record key post-operative metrics following abdominoplasty with the PEAK PlasmaBlade 4.0 versus current standard of care (SOC); and to evaluate performance metrics of the PEAK PlasmaBlade 4.0 during abdominoplasty.
Abdominoplasty is a cosmetic surgical procedure performed to correct abdominal elastosis with skin and fat redundancy. During the procedure, a scalpel and traditional electrosurgical device are used to cut away this excess skin and fat from the abdomen and the underlying muscles are tightened together with sutures.
The PEAK PlasmaBlade™ uses pulsed radiofrequency (RF) energy to enable precision cutting and coagulating at the point of application, without the thermal damage to surrounding tissues that is normally seen with traditional electrosurgery. The PlasmaBlade has received FDA clearance for use in plastic, general, and ear, nose, and throat (ENT) surgery, and has demonstrated significantly reduced serous drainage in tissue reduction surgeries, like abdominoplasty.
A total of twenty (20) human subjects were recruited from the local community against standardized inclusion/exclusion criteria. Once enrolled, each patient underwent placement of three sets of full-thickness comparison incisions in their abdominal skin with a standard scalpel, PlasmaBlade, and traditional electrosurgery at six (6) and three (3) weeks prior to abdominoplasty, and on the day of surgery under general anesthesia. Subjects were then randomized to undergo abdominoplasty with the PlasmaBlade or the SOC (scalpel and traditional electrosurgery). Following abdominoplasty, harvested healed incisions were submitted for histological analysis and burst strength testing and additional data were recorded in the 10 day post-operative period.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PEAK PlasmaBlade | Experimental | The PEAK PlasmaBlade will be used for the abdominoplasty procedure. |
|
| Standard of Care (SOC) | Active Comparator | The scalpel and electrocautery will be used for the abdominoplasty procedure. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PEAK PlasmaBlade | Device | The PEAK PlasmaBlade will be used for the abdominoplasty procedure. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Acute Thermal Injury Depth | Histological samples were created by first incising the area to be resected with all 3 modalities (PEAK PlasmaBlade, electrocautery, and scalpel) at 6 and 3 weeks before the operation. Then, the incised tissue was resected during the abdominoplasty and was assessed by analyzing incisions created in the resected area for histological measures. Acute thermal injury depth was assessed by incising the resected area during the abdominoplasty operation. | Immediately postoperative |
| Inflammatory Cell Count | Histological samples were created by first incising the area to be resected with all 3 modalities (PEAK PlasmaBlade, electrocautery, and scalpel) at 6 and 3 weeks before the operation. Then, the incised tissue was resected during the abdominoplasty and was assessed by analyzing incisions created in the resected area for histological measures. | 0, 3, and 6 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Total Drainage Output | 0 to 10 days postoperatively | |
| Change in Hemoglobin | The outcome measure is reported as change in hemoglobin, not the hemoglobin value itself. | Intraoperative |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Howard L Rosenberg, MD | El Camino Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| El Camino Surgery Center | Mountain View | California | 94040 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21701326 | Derived | Ruidiaz ME, Messmer D, Atmodjo DY, Vose JG, Huang EJ, Kummel AC, Rosenberg HL, Gurtner GC. Comparative healing of human cutaneous surgical incisions created by the PEAK PlasmaBlade, conventional electrosurgery, and a standard scalpel. Plast Reconstr Surg. 2011 Jul;128(1):104-111. doi: 10.1097/PRS.0b013e31821741ed. |
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| ID | Title | Description |
|---|---|---|
| FG000 | PEAK PlasmaBlade | The PEAK PlasmaBlade for the abdominoplasty procedure. |
| FG001 | Standard of Care (SOC) | The scalpel and electrocautery will be used for the abdominoplasty procedure. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | PEAK PlasmaBlade | The PEAK PlasmaBlade will be used for the abdominoplasty procedure. |
| BG001 | Standard of Care (SOC) | The scalpel and electrocautery will be used for the abdominoplasty procedure. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Acute Thermal Injury Depth | Histological samples were created by first incising the area to be resected with all 3 modalities (PEAK PlasmaBlade, electrocautery, and scalpel) at 6 and 3 weeks before the operation. Then, the incised tissue was resected during the abdominoplasty and was assessed by analyzing incisions created in the resected area for histological measures. Acute thermal injury depth was assessed by incising the resected area during the abdominoplasty operation. | Posted | Mean | Standard Deviation | micrometers | Immediately postoperative |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | PEAK PlasmaBlade | The PEAK PlasmaBlade will be used for the abdominoplasty procedure. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Seroma | Surgical and medical procedures |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Robert Swain, PhD | Medtronic Surgical Technologies | (+1-603) 294-5428 | robert.e.swain@medtronic.com |
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| ID | Term |
|---|---|
| D000084462 | Hyperthermia |
| ID | Term |
|---|---|
| D001832 | Body Temperature Changes |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D018882 | Heat Stress Disorders |
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| ID | Term |
|---|---|
| D059039 | Standard of Care |
| D004564 | Electrocoagulation |
| D004598 | Electrosurgery |
| ID | Term |
|---|---|
| D019984 | Quality Indicators, Health Care |
| D011787 | Quality of Health Care |
| D006298 | Health Services Administration |
| D017530 | Health Care Quality, Access, and Evaluation |
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| Standard of Care (SOC) | Procedure | The scalpel and electrocautery will be used for the abdominoplasty procedure. |
|
|
| Narcotic Consumption | Narcotic medications were coded to Fentanyl microgram equivalent units per kilogram. | Intraoperative and postoperative (0 to 10 days) |
| Postoperative Pain Levels | Wong-Baker FACES Visual Analog Scale, 0 (no hurt) to 10 (hurts worst). The results represent the mean of each subject's mean pain scores over 10 days. | Postoperative (0 to 10 days) |
| Activity Level | Sum of activity over 10 days postoperatively using a 0 (0% of normal) to 100 (100% of normal) visual analog scale. Subjects circled a number representing their activity level by tens (e.g., 10% of normal, 20% of normal). Subjects completed the scale daily through day 10. The results represent the mean cumulative value per patient. | Postoperative (0 to 10 days) |
| Diet Volume | Sum of diet volume (i.e., how much food the subject ate) over 10 days postoperatively using a 0 (0% of normal) to 100 (100% of normal) visual analog scale. Subjects circled a number representing their diet volume by tens (e.g., 10% of normal, 20% of normal). Subjects completed the scale daily through day 10. The results represent the mean cumulative value per patient. | Postoperative (0 to 10 days) |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Electrocautery |
The standard of care for abdominoplasty consists of scalpel (for the skin incision) and traditional electrosurgery (for the subcutaneous dissection). Traditional electrosurgical instruments are used for the cutting and coagulation of soft tissues. |
|
|
|
| Primary | Inflammatory Cell Count | Histological samples were created by first incising the area to be resected with all 3 modalities (PEAK PlasmaBlade, electrocautery, and scalpel) at 6 and 3 weeks before the operation. Then, the incised tissue was resected during the abdominoplasty and was assessed by analyzing incisions created in the resected area for histological measures. | Posted | Mean | Standard Deviation | cells per square millimeter | 0, 3, and 6 weeks |
|
|
|
|
| Secondary | Total Drainage Output | One subject was removed from the analysis of secondary variables owing to a protocol deviation. | Posted | Mean | Standard Deviation | mL | 0 to 10 days postoperatively |
|
|
|
|
| Secondary | Change in Hemoglobin | The outcome measure is reported as change in hemoglobin, not the hemoglobin value itself. | One subject was removed from the analysis of secondary variables owing to a protocol deviation. | Posted | Mean | Standard Deviation | g/dL | Intraoperative |
|
|
|
|
| Secondary | Narcotic Consumption | Narcotic medications were coded to Fentanyl microgram equivalent units per kilogram. | One subject was removed from the analysis of secondary variables owing to a protocol deviation. | Posted | Mean | Standard Deviation | Fentanyl microgram units/g | Intraoperative and postoperative (0 to 10 days) |
|
|
|
|
| Secondary | Postoperative Pain Levels | Wong-Baker FACES Visual Analog Scale, 0 (no hurt) to 10 (hurts worst). The results represent the mean of each subject's mean pain scores over 10 days. | One subject was removed from the analysis of secondary variables owing to a protocol deviation. | Posted | Mean | Standard Deviation | units on a scale | Postoperative (0 to 10 days) |
|
|
|
|
| Secondary | Activity Level | Sum of activity over 10 days postoperatively using a 0 (0% of normal) to 100 (100% of normal) visual analog scale. Subjects circled a number representing their activity level by tens (e.g., 10% of normal, 20% of normal). Subjects completed the scale daily through day 10. The results represent the mean cumulative value per patient. | One subject was removed from the analysis of secondary variables owing to a protocol deviation. | Posted | Mean | Standard Deviation | units on a scale | Postoperative (0 to 10 days) |
|
|
|
|
| Secondary | Diet Volume | Sum of diet volume (i.e., how much food the subject ate) over 10 days postoperatively using a 0 (0% of normal) to 100 (100% of normal) visual analog scale. Subjects circled a number representing their diet volume by tens (e.g., 10% of normal, 20% of normal). Subjects completed the scale daily through day 10. The results represent the mean cumulative value per patient. | One subject was removed from the analysis of secondary variables owing to a protocol deviation. | Posted | Mean | Standard Deviation | units on a scale | Postoperative (0 to 10 days) |
|
|
|
|
| 0 |
| 10 |
| 1 |
| 10 |
| EG001 | Standard of Care (SOC) | The scalpel and electrocautery will be used for the abdominoplasty procedure. | 0 | 10 | 3 | 10 |
| Extended drainage period | Surgical and medical procedures |
|
| Infection | Infections and infestations |
|
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| D014947 | Wounds and Injuries |
| D002425 | Cautery |
| D013812 | Therapeutics |
| D055011 | Ablation Techniques |
| D013514 | Surgical Procedures, Operative |
| CD3+ 3 weeks |
|
| CD3+ 6 weeks |
|
| CD68+ 0 weeks |
|
| CD68+ 3 weeks |
|
| CD68+ 6 weeks |
|
| 0.02 |
| 95 |
| No |
| Superiority or Other |
| CD3+ at 6 weeks | ANOVA | 0.71 | 95 | No | Superiority or Other |
| CD68+ at 0 weeks | ANOVA | 0.67 | 95 | No | Superiority or Other |
| CD68+ at 3 weeks | ANOVA | 0.01 | 95 | No | Superiority or Other |
| CD68+ at 6 weeks | ANOVA | 0.48 | 95 | No | Superiority or Other |
| 0.5900 |
| 95 |
| No |
| Superiority or Other |