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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.
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
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AC5 Topical Hemostatic Device | Experimental | The intervention in this arm is the application of a topical hemostatic agent (AC5) to a freshly excised skin lesion |
|
| Control | Placebo Comparator | The intervention in this arm is the application of saline (Control) to a freshly excised skin lesion |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AC5 Topical Hemostatic Device | Device | Randomized application of the hemostatic agent AC5 to one of two freshly excised lesions in each patient |
|
| Measure | Description | Time Frame |
|---|---|---|
| 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. | 30 Days Post Procedure |
| Measure | Description | Time Frame |
|---|---|---|
| Median Time to Hemostasis (Seconds) | Measure of time from application of treatment or control to the wound, to bleeding cessation | At time of application (Day 0) |
| Time to Hemostasis in Seconds Per Square Centimeter Wound Area |
| Measure | Description | Time Frame |
|---|---|---|
| Time to Hemostasis in Patients Who Were Taking or Not Taking Anti Platelet Medication | Day 0 |
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:
Female subjects must meet at least one of the following additional criteria:
Subjects willing to undergo pre-and post-clinical investigation blood and urine collection, physical exams and laboratory investigations.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jack Kelly, MD | Professor of Surgery | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University College Hospital | Galway | Ireland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 2868173 | Result | 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. |
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Patients were recruited who were to undergo excision of two skin lesions in the same sitting.
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| ID | Title | Description |
|---|---|---|
| FG000 | All Study Participants | All study participants had two freshly excised lesions, each randomized to either application of a topical hemostatic device (AC5) or control (saline) treatment. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Overall | Characteristics of the 46 patients enrolled in the study |
| 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 | 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. | Posted | Count of Participants | Participants | 30 Days Post Procedure |
|
30 days
Adverse events were assessed immediately after treatment (Day 0), Day 7, and Day 30.
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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 | AC5 Topical Hemostatic Device | The intervention in this arm is the application of a topical hemostatic agent (AC5) to a freshly excised skin lesion AC5 Hemostatic agent: Randomized application of the hemostatic agent AC5 to one of two freshly excised lesions in each patient |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Wound complication | Injury, poisoning and procedural complications | MedDRA (10.0) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Medical/Scientific Affairs | Arch Therapeutics, Inc | 617 431-2313 | jprats@archtherapeutics.com |
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| ID | Term |
|---|---|
| D012878 | Skin Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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Measure of time from application of treatment or control to the wound, to bleeding cessation/ divided by wound area
| At time of application (Day 0) |
| 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. | 7 and 30 Days Post Procedure |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Antiplatelet therapy | Count of Participants | Participants |
|
| Control |
The intervention in this arm is the randomized application of saline (Control) to one of two freshly excised lesions in each patient. Number in this arm refers to lesions |
|
|
| Secondary | Median Time to Hemostasis (Seconds) | Measure of time from application of treatment or control to the wound, to bleeding cessation | Analysis is performed per wound (2/patient, one randomized to AC5 the second to control), that is, 46 patients with a total of 96 wounds. | Posted | Median | Full Range | seconds | At time of application (Day 0) |
|
|
|
| Secondary | 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 | Analysis is performed per wound (2/patient, one randomized to AC5 the second to control), that is, 46 patients with a total of 96 wounds. | Posted | Median | Full Range | seconds/cm2 | At time of application (Day 0) |
|
|
|
| Secondary | 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. | Analysis is performed per wound (2/patient, one randomized to AC5 the second to control), that is, 46 patients with a total of 96 wounds. | Posted | Number | wounds | 7 and 30 Days Post Procedure |
|
|
|
| Other Pre-specified | Time to Hemostasis in Patients Who Were Taking or Not Taking Anti Platelet Medication | The overall number of patients is 46, 10 of whom were taking anti platelet therapy at the time of the procedure. | Posted | Median | Full Range | seconds | Day 0 |
|
|
|
| 0 |
| 46 |
| 0 |
| 46 |
| 13 |
| 46 |
| EG001 | Control | The intervention in this arm is the application of saline (Control) to a freshly excised skin lesion AC5 Hemostatic agent: Randomized application of the hemostatic agent AC5 to one of two freshly excised lesions in each patient | 0 | 46 | 0 | 46 | 13 | 46 |
| Secretion discharge | General disorders | MedDRA (10.0) | Systematic Assessment |
|
| Fibrin D dimer increased | Investigations | MedDRA (10.0) | Systematic Assessment |
|
| Wound hemorrhage | Injury, poisoning and procedural complications | MedDRA (10.0) | Systematic Assessment |
|
| Back pain | Musculoskeletal and connective tissue disorders | MedDRA (10.0) | Systematic Assessment |
|
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| Not taking antiplatelet therapy |
|
|