Fibrin Sealant VH S/D 500 S-apr in Hepatic Resection
- Conditions
- Bleeding (Oozing) in Hepatic Resection
- Interventions
- Other: Manual compression
- Registration Number
- NCT01244425
- Lead Sponsor
- Baxter Healthcare Corporation
- Brief Summary
The purpose of the study is to compare safety and efficacy of Fibrin Sealant (FS) Vapor Heated (VH) S/D 500 s-apr with manual compression as a supportive treatment of local bleeding (i.e. oozing) in hepatic resection surgery when standard surgical techniques are insufficient.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 70
- Signed informed consent obtained from the subject before any study-related activities
- Subject's age is 18 years or above
- Subject will undergo planned, elective resection of at least 1 anatomical segment of the liver for any reason by laparotomy
- Subject is willing and able to comply with the requirements of the protocol
- Female subjects of childbearing potential must present with a negative serum or urine pregnancy test within 72 hours before the elective liver resection
- Female subjects of childbearing potential must agree to employ adequate birth control measures for the time of their participation in the study
Intra-Operative Inclusion Criteria (before randomization):
- Resection of at least 1 anatomical segment of the liver has been performed
- Oozing from the cut surface of the liver persists after conventional resection procedure and primary control of arterial and venous bleeding by sutures, ligations, clips, vascular stapler, point electrocautery or focal radiofrequency ablation
- Need for additional supportive hemostatic treatment to stop bleeding (i.e. diffuse oozing) of the liver resection area
Pre-Operative
- Subject needs emergency liver surgery
- Subject will undergo liver resection via laparoscopic procedure
- Subject has known congenital coagulation disorder (e.g. hemophilia)
- Subject has known hypersensitivity to any ingredient of the investigational medicinal product
- Suspected inability or unwillingness of the subject to comply with trial procedures
- If female, subject is pregnant or lactating at the time of study enrollment
- Subject has already participated in this study (each subject can only be enrolled once)
- Subject has participated in another clinical study involving an investigational product or investigational device within 30 days prior to study enrollment or is scheduled to participate in another clinical study involving an investigational product or investigational device during the course of this study
Intra-operative Exclusion Criteria (before randomization):
- Occurrence of any severe surgical complication that require resuscitation or deviation from the planned surgical procedure
- Disseminated intravascular coagulopathy (DIC)
- Application of any topical hemostatic material on the resection surface of the liver prior to application of the study treatment
- Radiofrequency precoagulation of the liver resection surface, except focal use of radiofrequency as primary hemostatic treatment
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description FS VH S/D 500 s-apr Fibrin Sealant (FS) VH S/D 500 s-apr Fibrin Sealant, Vapor Heated, Solvent/Detergent treated with 500 IU/mL thrombin and synthetic aprotinin (FS VH S/D 500 s-apr), not to exceed 20mL per participant. Hemostasis will be assessed at 4, 6, 8 and 10 minutes after application of the study treatment. Manual compression - Control Manual compression A dry surgical gauze swab will be used to apply by hand an even light pressure onto the oozing resection surface of the liver. Hemostasis will be assessed at 4, 6, 8 and 10 minutes after application of the study treatment.
- Primary Outcome Measures
Name Time Method Percentage of Participants With Intraoperative Hemostasis at 4 Minutes After Treatment Application 4 minutes post start of treatment application Hemostasis defined as no visible bleeding on the liver resection surface (liver surgical site) after treatment application. Hemostasis had to be maintained until surgical closure. Time recording started with treatment application, ie, with the start of spraying Fibrin Sealant, Vapor Heated, Solvent/Detergent treated with 500 IU/mL thrombin and synthetic aprotinin (FS VH S/D 500 s-apr) or with the application of manual compression.
The following were regarded as treatment failures:
* No hemostasis achieved at 4 minutes post treatment application (for the FS VH S/D 500 s-apr arm, the "time to hemostasis" was used; a time window of +5 seconds was acceptable for showing a success)
* Additional hemostatic treatment (ie, hemostatics in addition to the randomized treatment) was required
* Reapplication of FS VH S/D 500 s-apr after 4 minutes
* Intraoperative rebleeding after the first 4 minutes of the observation period
- Secondary Outcome Measures
Name Time Method Percentage of Participants With Intraoperative Hemostasis at 6 Minutes After Application of the Randomized Treatment 6 minutes after start of treatment application Hemostasis defined as no visible bleeding on the liver resection surface (liver surgical site) after treatment application. Hemostasis had to be maintained until surgical closure. Time recording started with treatment application, ie, with the start of spraying Fibrin Sealant, Vapor Heated, Solvent/Detergent treated with 500 IU/mL thrombin and synthetic aprotinin (FS VH S/D 500 s-apr) or with the application of manual compression.
Percentage of Participants With Intraoperative Hemostasis at 8 Minutes After Application of the Randomized Treatment 8 minutes after start of treatment application Hemostasis defined as no visible bleeding on the liver resection surface (liver surgical site) after treatment application. Hemostasis had to be maintained until surgical closure. Time recording started with treatment application, ie, with the start of spraying Fibrin Sealant, Vapor Heated, Solvent/Detergent treated with 500 IU/mL thrombin and synthetic aprotinin (FS VH S/D 500 s-apr) or with the application of manual compression.
Percentage of Participants With Intraoperative Hemostasis at 10 Minutes After Application of the Randomized Treatment 10 minutes after start of treatment application Hemostasis defined as no visible bleeding on the liver resection surface (liver surgical site) after treatment application. Hemostasis had to be maintained until surgical closure. Time recording started with treatment application, ie, with the start of spraying Fibrin Sealant, Vapor Heated, Solvent/Detergent treated with 500 IU/mL thrombin and synthetic aprotinin (FS VH S/D 500 s-apr) or with the application of manual compression.
Percentage of Participants With Intraoperative Rebleeding After Occurrence of Hemostasis Intraoperative day 0 Intraoperative rebleeding from the treated liver resection surface after occurrence of hemostasis.
Percentage of Participants With Postoperative Rebleeding Postoperative until discharged from surgical ward Rebleeding until discharged from the surgical ward, defined as any rebleeding from the treated liver resection surface requiring surgical reexploration
Percentage of Participants With Transfusion Requirements Until Discharged From Surgical Ward Intra- and postoperative until discharged from surgical ward Transfusions administered included whole blood, packed red blood cells, fresh frozen plasma, and thrombocyte concentrate.
Median Total Volume of Postoperative Drainage Fluid Within 48 Hours After Surgery Within 48 hours after surgery