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This clinical trial evaluates the effectiveness and safety of a collagen-based hemostatic agent containing thrombin in patients undergoing spinal surgery. The study compares this investigational product with an existing hemostatic agent to assess whether it performs equally well in controlling surgical bleeding. Patients with spinal stenosis, tumors, or trauma who require spinal surgery will be enrolled. The hemostat will be applied intraoperatively when grade 3 bleeding is observed. The study aims to determine how well the product works in achieving hemostasis and its safety when it is used during surgery.
This was a randomized, single-blind, active-controlled clinical trial designed to assess the non-inferiority of a collagen-based thrombin-containing topical hemostat (CollaStat) compared to an existing hemostatic agent (Floseal) in patients undergoing spinal surgery. The investigational product was designed to be highly biocompatible to reduce adverse effects in case of in-body residue after application. Patients who underwent spinal surgery due to spinal stenosis, tumors, or trauma were enrolled and randomized in a 1:1 ratio. The hemostatic products were applied intraoperatively at bleeding sites classified as grade 3. For grade 4 or 5 bleeding, temporary hemostatic procedures were performed first to reduce bleeding intensity before applying the assigned hemostat. The study's primary endpoint was the hemostasis success rate, defined as the achievement of hemostasis within 1 minute, 2 minutes, 3 minutes, 6 minutes, and 10 minutes of product application without additional intervention. Secondary outcomes included time to hemostasis, number of hemostatic units used per patient, volume of postoperative surgical drainage, length of hospital stay, incidence of intraoperative rebleeding, occurrence of postoperative hematoma or surgical site infection, and overall hemostatic effect assessed across all treated bleeding sites.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study Group | Experimental | Group applied with CollaStat® |
|
| Control Group | Active Comparator | Group applied with Floseal® |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CollaStat® | Device | Clinical subjects are enrolled after the clinical investigator confirms that there are bleeding sites where hemostasis by normal procedures (compression, suturing, electrosurgical scalpel, etc.) is ineffective or difficult to perform. To arrest intraoperative bleeding, the study group is treated with Dalim Tissen's CollaStat® and compressed with general gauze. |
| Measure | Description | Time Frame |
|---|---|---|
| Hemostasis success rate | After applying the haemostatic agent to the bleeding site, gentle compression is performed using surgical gauze. After lifting the gauze and washing off the excess hemostatic agent, check if hemostasis is maintained | Hemostasis at the first bleeding site is confirmed at 1 minute, 2 minutes, 3 minutes, 6 minutes, and 10 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Time to hemostasis | Record the time point when hemostasis is achieved. | Intraoperation |
| Number of hemostats used | Record the number of hemostats used until hemostasis. |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Gangnam Severance Hospital | Seoul | Gangnam-gu | 06273 | South Korea | ||
| Yongin Severance Hospital |
Undecided. The plan for sharing individual participant data has not yet been determined.
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| ID | Term |
|---|---|
| D013120 | Spinal Cord Neoplasms |
| D013124 | Spinal Injuries |
| D013130 | Spinal Stenosis |
| D016063 | Blood Loss, Surgical |
| ID | Term |
|---|---|
| D016543 | Central Nervous System Neoplasms |
| D009423 | Nervous System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| Floseal® | Device | Clinical subjects are enrolled after the clinical investigator confirms that there are bleeding sites where hemostasis by normal procedures (compression, suturing, electrosurgical scalpel, etc.) is ineffective or difficult to perform. To arrest intraoperative bleeding, the control group is treated with Baxter's Floseal® and compressed with general gauze |
|
| Intraoperation |
| Length of Hospital Stay | Length of hospital stay is defined as the number of days from the date of surgery (Visit 2) to the date of hospital discharge. | From the date of surgical operation (Visit 2) until the date of hospital discharge, assessed up to 1 week (±3 days) after surgery |
| Incidence of adverse events | Adverse events include hematoma and infection. | From first application of the investigational medical device through end of follow-up (up to 8 weeks post-surgery) |
| Drain amount | Record the drain amount until the 3rd postoperative day. | 3 days after surgery |
| Presence of rebleeding at the index bleeding site | From first application (Visit 2; day of surgery) through end of follow-up (up to 8 weeks post-surgery) |
| Evaluation of Handling Characteristics (as Assessed by the Surgeon) | Hemostasis will be assessed intraoperatively at all treated bleeding sites after application of the investigational product (IP). Only the assigned IP should be used for the same patient. | Intraoperative |
| Yongin-si |
| Giheung-gu |
| 16995 |
| South Korea |
| Severance Hospital, Yonsei University Health Syetem | Seoul | Seodaemun-gu | 03722 | South Korea |
| D013118 |
| Spinal Cord Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D019567 | Back Injuries |
| D014947 | Wounds and Injuries |
| D013122 | Spinal Diseases |
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
| D006470 | Hemorrhage |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D007431 | Intraoperative Complications |