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Completed

NCT Number: NCT02227706

The Paediatric EVICEL® Soft Tissue and Parenchymal Organ Bleeding Study

To evaluate the safety and effectiveness of EVICEL® Fibrin Sealant (Human) as an adjunct to achieve haemostasis during surgery in paediatric patients.

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Key information

Age range

Up to 17 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Clinical Investigation Site #31, Brussels, Belgium

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About this study

This is a prospective, randomized, controlled, clinical study comparing EVICEL® to SURGICEL®, as an adjunct to haemostasis when conventional methods of controlling bleeding are ineffective or impractical during surgery in paediatric patients.

At least 40 qualified paediatric subjects with an appropriate mild or moderate Target Bleeding Site (TBS) will be randomized in a 1:1 allocation ratio to either EVICEL® or SURGICEL®. Haemostasis will be assessed at 4, 7 and 10 minutes from randomization.

Enrolment will be staggered by age (as required by the European Medicines Agency (EMA) Paediatric Committee). The first group enrolled will include at least 36 subjects aged ≥1 years to <18 years of age. When enrolment of the first group is complete; enrolment of a subsequent group will commence and include at least 4 subjects from birth (including neonates ≤37 weeks gestation) to <1 years of age.

Subjects will be followed post-operatively through hospital discharge and at 30 days (±14 days) post-surgery.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Paediatric subjects birth to <18 years of age, requiring non-emergent laparoscopic or open (through peritoneum or pleura) abdominal, retroperitoneal, pelvic or thoracic (non-cardiac) surgical procedures. i) The first 36 subjects to be enrolled will be subjects ≥1 years to <18 years of age. ii) The next 4 subjects to be enrolled will be subjects birth to <1years of age.
  • The subject and/or subject's parent or legal guardian must be willing to give permission for the subject to participate in the trial, and provide written informed consent for the subject. If possible, assent must be obtained from paediatric subjects who possess the intellectual and emotional ability to comprehend the concepts involved in the trial. If the paediatric subject is not able to provide assent (due to age, maturity and/or inability to intellectually and/or emotionally comprehend the trial), the parent/legal guardian's written informed consent for the subject will be acceptable for the subject to be included in the study; and
  • Presence of an appropriate mild or moderate bleeding soft tissue or parenchymal organ Target Bleeding Site identified intra-operatively by the surgeon;

Exclusion criteria

  • Subjects with known intolerance to blood products or to one of the components of the study product or is unwilling to receive blood products;
  • Female subjects, who are of childbearing age (i.e. adolescent), who are pregnant or nursing;
  • Subject is currently participating or, during the study is planned to participate in any other investigational device or drug trial without prior approval from the Sponsor;
  • Subjects who are known, current alcohol and/or drug abusers;
  • Subjects admitted for trauma surgery;
  • Subjects with any pre or intra-operative findings identified by the surgeon that may preclude conduct of the study procedure;
  • Subjects with Target Bleeding Site in an actively infected field (Class III Contaminated or Class IV Dirty or Infected)
  • Anastomotic bleeding sites will not be considered for randomization.

Treatment and study plan

EVICEL® Fibrin Sealant

Biological

EVICEL® is a human plasma-derived fibrin sealant. EVICEL® consists of two components: a concentrate of Human Clottable Protein (referred to as Biological Component 2; BAC2) and a solution of Human Thrombin. No material of animal origin is present in the product

Other names: EVICEL, fibrin sealant

SURGICEL® Absorbable Hemostat

Device

SURGICEL® Absorbable Hemostat (oxidized regenerated cellulose) is a sterile absorbable knitted fabric prepared by the controlled oxidation of regenerated cellulose.

Other names: oxidized regenerated cellulose

Primary outcomes

  1. Absolute Time to Haemostasis

    Time frame: From randomisation (identification of appropriate target bleeding site) to final fascial closure (median study procedure time 164.0 minutes [range 47.0 - 506.0 minutes])

    Absolute time to haemostasis, defined as absolute time when there was no detectable bleeding at the Target Bleeding Site (TBS).

Secondary outcomes

  1. Number of Participants Achieving Haemostasis at 4 Minutes

    Time frame: Intra-operatively from randomisation to 4 minutes after randomisation

    Number of participants achieving haemostasis at target bleeding site at 4 minutes. This endpoint is assessing haemostasis at 4 minutes only and not maintenance of haemostasis following this timepoint. As rebleeding may occur between timepoints, subsequent rebleeding (if any) is detailed in treatment failure analysis.

  2. Number of Participants Achieving Haemostasis at 7 Minutes

    Time frame: Intra-operatively from randomisation to 7 minutes after randomisation

    Number of Participants Achieving Haemostasis at Target Bleeding Site at 7 Minutes. This endpoint is assessing haemostasis at 7 minutes only and is not affected by haemostasis assessment prior to 7 minutes or maintenance of haemostasis following this 7 minute assessment. As rebleeding may occur between timepoints, subsequent rebleeding (if any) is detailed in treatment failure analysis.

  3. Number of Participants Achieving Haemostasis at 10 Minutes

    Time frame: Intra-operatively from randomisation to 10 minutes after randomisation

    Number of Participants Achieving Haemostasis at Target Bleeding Site at 10 Minutes. This endpoint is assessing haemostasis at 10 minutes only and is not affected by haemostasis assessments prior to 10 minutes or maintenance of haemostasis following this 10 minute assessment. As rebleeding may occur between timepoints, subsequent rebleeding (if any) is detailed in treatment failure analysis).

  4. Incidence of Treatment Failures (Number of Participants)

    Time frame: 10 minutes

    Defined as haemostasis not achieved within 10 minutes or bleeding requiring treatment other than re-application of the assigned haemostatic adjunct within 10 minutes.

  5. Estimated Blood Loss

    Time frame: During surgical procedure (first incision to final fascial closure (median study procedure time 164.0 minutes [range 47.0 - 506.0 minutes])

    Blood loss during surgical procedure (includes but not limited to the target bleeding site)

  6. Blood Transfusion

    Time frame: From surgical procedure to 30 day (+/-14 day) follow-up visit

    Participants requiring a blood transfusion

  7. Participants Receiving a Blood Transfusion

    Time frame: From surgery to 30 day (+/-14 day) follow-up visit

    Details of blood products received (if any)

  8. Changes in Laboratory Parameters Haemoglobin and Mean Corpuscular Haemoglobin Concentration

    Time frame: Baseline (within 21 days prior to surgery) to Hospital Discharge (within 72 hours of discharge)

    Laboratory parameter changes from baseline to post operative hospital discharge (Haemoglobin and Mean Corpuscular Haemoglobin Concentration)

  9. Changes in Laboratory Parameters Haematocrit

    Time frame: Baseline (within 21 days prior to surgery) to Hospital Discharge (within 72 hours of discharge)

    Change in red blood cell proportion in volume in the blood from baseline to post operative hospital discharge

  10. Changes in Laboratory Parameters Platelet Count and White Cell Count

    Time frame: Baseline (within 21 days prior to surgery) to Hospital Discharge (within 72 hours)

    Laboratory parameter changes from baseline to post operative hospital discharge

  11. Changes in Laboratory Parameters Red Blood Cell Count

    Time frame: Baseline (within 21 days prior to surgery) to Hospital Discharge (within 72 hours of discharge)

    Laboratory parameter changes from baseline to post operative hospital discharge

  12. Changes in Laboratory Parameters Mean Corpuscular Haemoglobin

    Time frame: Baseline (within 21 days prior to surgery) to Hospital Discharge (within 72 hours of discharge)

    Laboratory parameter changes from baseline to post operative hospital discharge

  13. Changes in Laboratory Parameters Mean Corpuscular Volume

    Time frame: Baseline (within 21 days prior to surgery) to Hospital Discharge (within 72 hours of discharge)

    Laboratory parameter changes from baseline to post operative hospital discharge

  14. Changes in Laboratory Parameters Neutrophils, Lymphocytes, Monocytes, Eosinophils and Basophils

    Time frame: Baseline (within 21 days prior to surgery) to Hospital Discharge (within 72 hours of discharge)

    Laboratory parameter changes in volume from baseline to post operative hospital discharge (Neutrophils, Lymphocytes, Monocytes, Eosinophils and Basophils)

  15. Changes in Laboratory Parameters Activated Partial Thromboplastin Time and Prothrombin Time

    Time frame: Baseline (within 21 days prior to surgery) to Hospital Discharge (within 72 hours of discharge)

    Laboratory parameter changes from baseline to post operative hospital discharge (Activated Partial Thromboplastin Time and Prothrombin Time)

  16. Changes in Laboratory Parameters International Normalised Ratio

    Time frame: Baseline (within 21 days prior to surgery) to Hospital Discharge (within 72 hours of discharge)

    Standardized measurement of the change in blood clotting time from baseline to post operative hospital discharge

Other outcomes

  1. Number of Participants With a Thrombotic Event

    Time frame: From randomisation up to 30 days (+/- 14 days) following surgery

    Number of Participants with a Thrombotic Event.

  2. Number of Participants With an Adverse Event Related to Re-bleeding at Target Bleeding Site

    Time frame: From randomisation to 30 days (+/- 14 days) following surgery

    Number of Participants with an Adverse Event Related to Re-bleeding at Target Bleeding Site.

Sponsors and collaborators

Lead sponsor

Ethicon, Inc.

Industry

Registry information

Official study title

A Prospective, Randomized, Controlled Study Evaluating EVICEL® Fibrin Sealant as an Adjunct to Haemostasis During Abdominal, Retroperitoneal, Pelvic or Thoracic (Non-Cardiac) Surgery in Paediatric Patients

Important dates

Study start
2014
Primary completion
2019
Study completion
2019
First posted
Aug 28, 2014
Registry last updated
Aug 31, 2020

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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