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Evaluation of an Absorbable Surgical Hemostatic Agent: Thrombi-Gel® Versus Gelfoam-Thrombin

Evaluation of an Absorbable Surgical Hemostatic Agent: Thrombi-Gel® Versus Gelfoam-Thrombin

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00652314
Acronym
Control
Enrollment
97
Registered
2008-04-03
Start date
2008-03-31
Completion date
2010-01-31
Last updated
2016-03-07

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Operation Site Bleed

Keywords

Hemostatic products, Surgical hemostasis, Thrombi-gel, Gelatin Sponge, Time to hemostasis

Brief summary

This trial is designed as a prospective, multi-center, randomized, feasibility clinical trial to evaluate the safety and efficacy of Thrombi-Gel as an absorbable surgical hemostat. Within this clinical evaluation, Thrombi-Gel will be compared to the current standard of care, a gelatin sponge (Gelfoam) plus Thrombin JMI, by using a 2:1 randomization ratio. Subjects will be randomized to one of two (2) treatment groups. One (1) group will be treated with Thrombi-Gel, while one (1) group will be treated with the gelatin sponge plus thrombin. All study data will be analyzed according to the subjects' assigned randomization group assignment, regardless of the treatment actually delivered.

Detailed description

This is a prospective, randomized, multi-center investigation with a minimum of seventy five (75) study subjects designed to evaluate the safety and effectiveness of the Thrombi-Gel product as an absorbable hemostat in the surgical patient population. Subjects who are undergoing orthopedic/spinal, general, cardiac, hepatic or vascular surgical procedures should be considered for this investigation. Subjects can be pre-screened utilizing standard of care data for the specified inclusion/exclusion criteria to ensure that they are eligible for treatment in the investigation. If the subject appears to qualify for the investigation, the subject will then be asked to give his/her written informed consent. If, during surgery, the surgeon encounters a bleeding site that he or she is unable or unwilling to easily control due to failure or impracticality of conventional methods (sutures and/or cautery), the subject may be enrolled and randomized to receive either the investigational or control treatment. If the subject has multiple bleeding sites, each site to a maximum of 5 sites, may be treated with the assigned surgical hemostat. However, only the first site treated will be used to determine study objectives. All subjects will be followed through their hospitalization. A follow-up evaluation will be conducted at approximately 30 and 60 days post-procedure to determine the long-term effectiveness of the hemostatic treatment received, incidence of late adverse events, and interim immunologic response to the study treatment device. Follow-up evaluations will include obtaining a blood specimen that evaluates for antibody development, coagulation, and Factor Va testing. Blood samples will be sent to independent labs for analysis. From baseline to the final study exam, data pertaining to the investigational objectives will be recorded on the appropriate case report forms at the predetermined study intervals. The investigation will be conducted at a minimum of five (5) sites, but no more than fifteen (15) sites.

Interventions

Applicaton of Hemostatic product during surgery

Sponsors

King Pharmaceuticals is now a wholly owned subsidiary of Pfizer
CollaboratorINDUSTRY
Vascular Solutions LLC
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

1. The subject is 18 years of age or older 2. The subject is undergoing an orthopedic/spinal, general, cardiac, hepatic, or vascular surgical procedure (neurosurgical, ophthalmic or urological procedures must be excluded) 3. The subject is willing and able to provide appropriate informed consent 4. The subject is willing and able to comply with the requirements of the study protocol, including the predefined follow-up evaluations Inclusion criteria to be determined during the surgical procedure: 1\. The subject has an intraoperative bleeding site which the surgeon is unable or unwilling to easily control with conventional methods (cautery, sutures)

Exclusion criteria

1. The subject is known or suspected to be pregnant (verified in a manner consistent with institution's standard of care), or is lactating 2. The subject has a known allergy to bovine derived products or any other materials used in the Thrombi-Gel product 3. The subject has an active infection at the surgical site 4. The use of hemostatic agents are contraindicated for the subject 5. The subject has a known bleeding disorder (including thrombocytopenia \[\< 100,000 platelet count\], thrombobasthenia, hemophilia, or von Willebrand disease) 6. The subject has received antibiotic solutions/powders at the intended application site 7. The subject has had surgery at the intended application site ≤ 6 months before the current surgical procedure 8. The subject is unavailable for follow-up 9. The subject is currently participating in another investigational device or drug trial 10. The subject has previously participated in this trial (Protocol 0307) or the Thrombi-Paste trial (Protocol 0507)

Design outcomes

Primary

MeasureTime frameDescription
The Primary Objective of This Investigation is to Gather Information to Support the Effectiveness of Thrombi-Gel as Compared to a Gelatin Sponge (Gelfoam) Plus Thrombin as an Adjunct to Hemostasis in Multi-specialty Surgical Settings.Time to hemostasis (minutes)Evaluation for hemostasis began immediately following application of the safety product. Hemostasis assessments were to be made every minute for the first 10 minutes post application. If hemostasis was not observed within 10 minutes, the treatment site was to be monitored and the research teams were asked to record the specific number of minutes until hemostasis was observed.

Secondary

MeasureTime frameDescription
Effectiveness: Device Success (Defined as the Number of Subjects With First Bleeding Site Applications for Which Hemostasis Was Obtained Within 6 Minutes of Study Device Application Without the Need for Adjunctive Treatment)Procedure, up to 6 minutes post procedure
Effectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Procedure (application through end of procedure)Ease of application to bleeding site as assessed by surgeon questionnaire for hemostatic handling characteristics.
Safety: Incidence Rate of Device-related Adverse EventsProcedure, up to 60 days post procedure
Safety: Immunological Testing for Factor Va Antibodies and Coagulation Parameters0 day, 30 day, and 60 days post procedure

Countries

United States

Participant flow

Participants by arm

ArmCount
1 - Thrombi-gel Treatment
Thrombi-gel treatment Thrombi-Gel: Applicaton of Hemostatic product during surgery
62
2 - Gelatin Sponge (Gelfoam) Plus Thrombin
Gelatin Sponge (Gelfoam) plus thrombin Thrombi-Gel: Applicaton of Hemostatic product during surgery
35
Total97

Baseline characteristics

Characteristic1 - Thrombi-gel Treatment2 - Gelatin Sponge (Gelfoam) Plus ThrombinTotal
Age, Customized
>= to 18 Years
62 participants35 participants97 participants
Sex: Female, Male
Female
37 Participants21 Participants58 Participants
Sex: Female, Male
Male
25 Participants14 Participants39 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
33 / 6222 / 35
serious
Total, serious adverse events
11 / 625 / 35

Outcome results

Primary

The Primary Objective of This Investigation is to Gather Information to Support the Effectiveness of Thrombi-Gel as Compared to a Gelatin Sponge (Gelfoam) Plus Thrombin as an Adjunct to Hemostasis in Multi-specialty Surgical Settings.

Evaluation for hemostasis began immediately following application of the safety product. Hemostasis assessments were to be made every minute for the first 10 minutes post application. If hemostasis was not observed within 10 minutes, the treatment site was to be monitored and the research teams were asked to record the specific number of minutes until hemostasis was observed.

Time frame: Time to hemostasis (minutes)

ArmMeasureValue (MEAN)Dispersion
1 - Thrombi-gel TreatmentThe Primary Objective of This Investigation is to Gather Information to Support the Effectiveness of Thrombi-Gel as Compared to a Gelatin Sponge (Gelfoam) Plus Thrombin as an Adjunct to Hemostasis in Multi-specialty Surgical Settings.4.01 Time to hemostasis (minutes)Standard Deviation 4.15
2 - Gelatin Sponge (Gelfoam) Plus ThrombinThe Primary Objective of This Investigation is to Gather Information to Support the Effectiveness of Thrombi-Gel as Compared to a Gelatin Sponge (Gelfoam) Plus Thrombin as an Adjunct to Hemostasis in Multi-specialty Surgical Settings.3.72 Time to hemostasis (minutes)Standard Deviation 4.75
Secondary

Effectiveness: Device Success (Defined as the Number of Subjects With First Bleeding Site Applications for Which Hemostasis Was Obtained Within 6 Minutes of Study Device Application Without the Need for Adjunctive Treatment)

Time frame: Procedure, up to 6 minutes post procedure

ArmMeasureValue (NUMBER)
1 - Thrombi-gel TreatmentEffectiveness: Device Success (Defined as the Number of Subjects With First Bleeding Site Applications for Which Hemostasis Was Obtained Within 6 Minutes of Study Device Application Without the Need for Adjunctive Treatment)50 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Device Success (Defined as the Number of Subjects With First Bleeding Site Applications for Which Hemostasis Was Obtained Within 6 Minutes of Study Device Application Without the Need for Adjunctive Treatment)29 participants
Secondary

Effectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)

Ease of application to bleeding site as assessed by surgeon questionnaire for hemostatic handling characteristics.

Time frame: Procedure (application through end of procedure)

Population: Note that the number of participants analyzed (62 and 33) applies to each set of five rows below which apply to the following categories: Ease of application to bleeding site, conformance to tissue surfaces, ease of delivery to hard to reach surfaces, and ease of preparation for use.

ArmMeasureGroupValue (NUMBER)
1 - Thrombi-gel TreatmentEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of application to bleeding site - 1 (easy)57 participants
1 - Thrombi-gel TreatmentEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of application to bleeding site - 25 participants
1 - Thrombi-gel TreatmentEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of application to bleeding site - 30 participants
1 - Thrombi-gel TreatmentEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of application to bleeding site - 40 participants
1 - Thrombi-gel TreatmentEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of application to bleeding site - 5 (hard)0 participants
1 - Thrombi-gel TreatmentEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Conformance to tissue surfaces - 1 (well)47 participants
1 - Thrombi-gel TreatmentEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Conformance to tissue surfaces - 215 participants
1 - Thrombi-gel TreatmentEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Conformance to tissue surfaces - 30 participants
1 - Thrombi-gel TreatmentEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Conformance to tissue surfaces - 40 participants
1 - Thrombi-gel TreatmentEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Conformance to tissue surfaces - 50 participants
1 - Thrombi-gel TreatmentEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of delivery to hard to reach surfaces-1(easy)38 participants
1 - Thrombi-gel TreatmentEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of delivery to hard to reach surfaces - 214 participants
1 - Thrombi-gel TreatmentEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of delivery to hard to reach surfaces - 33 participants
1 - Thrombi-gel TreatmentEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of delivery to hard to reach surfaces - 40 participants
1 - Thrombi-gel TreatmentEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of delivery to hard to reach surfaces-5(hard)0 participants
1 - Thrombi-gel TreatmentEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of preparation for use - 1 (easy)56 participants
1 - Thrombi-gel TreatmentEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of preparation for use - 24 participants
1 - Thrombi-gel TreatmentEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of preparation for use - 32 participants
1 - Thrombi-gel TreatmentEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of preparation for use - 40 participants
1 - Thrombi-gel TreatmentEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of preparation for use - 50 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of preparation for use - 36 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of application to bleeding site - 1 (easy)29 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of delivery to hard to reach surfaces-1(easy)24 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of application to bleeding site - 24 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of preparation for use - 1 (easy)24 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of application to bleeding site - 30 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of delivery to hard to reach surfaces - 25 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of application to bleeding site - 40 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of preparation for use - 50 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of application to bleeding site - 5 (hard)0 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of delivery to hard to reach surfaces - 31 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Conformance to tissue surfaces - 1 (well)28 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of preparation for use - 23 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Conformance to tissue surfaces - 24 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of delivery to hard to reach surfaces - 40 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Conformance to tissue surfaces - 31 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of preparation for use - 40 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Conformance to tissue surfaces - 40 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Ease of delivery to hard to reach surfaces-5(hard)0 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinEffectiveness: Hemostatic Handling Characteristics (Surgeon's Questionnaire)Conformance to tissue surfaces - 50 participants
Secondary

Safety: Immunological Testing for Factor Va Antibodies and Coagulation Parameters

Time frame: 0 day, 30 day, and 60 days post procedure

ArmMeasureGroupValue (NUMBER)
1 - Thrombi-gel TreatmentSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersBovine FV/Va (30 Day)17 participants
1 - Thrombi-gel TreatmentSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersHuman FV/Va (0 Day)9 participants
1 - Thrombi-gel TreatmentSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersBovine Thrombin (0 Day)12 participants
1 - Thrombi-gel TreatmentSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersHuman FV/Va (30 Day)12 participants
1 - Thrombi-gel TreatmentSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersBovine FV/Va (0 Day)11 participants
1 - Thrombi-gel TreatmentSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersHuman FV/Va (60 Day)10 participants
1 - Thrombi-gel TreatmentSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersBovine Thrombin (30 Day)15 participants
1 - Thrombi-gel TreatmentSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersHuman Thrombin (0 Day)3 participants
1 - Thrombi-gel TreatmentSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersBovine FV/Va (60 Day)11 participants
1 - Thrombi-gel TreatmentSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersHuman Thrombin (30 Day)7 participants
1 - Thrombi-gel TreatmentSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersBovine Thrombin (60 Day)14 participants
1 - Thrombi-gel TreatmentSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersHuman Thrombin (60 Day)4 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersBovine Thrombin (60 Day)4 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersBovine FV/Va (0 Day)3 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersBovine FV/Va (30 Day)9 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersBovine FV/Va (60 Day)7 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersBovine Thrombin (0 Day)4 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersBovine Thrombin (30 Day)7 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersHuman Thrombin (60 Day)3 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersHuman FV/Va (0 Day)7 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersHuman FV/Va (30 Day)10 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersHuman FV/Va (60 Day)5 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersHuman Thrombin (0 Day)2 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinSafety: Immunological Testing for Factor Va Antibodies and Coagulation ParametersHuman Thrombin (30 Day)3 participants
Secondary

Safety: Incidence Rate of Device-related Adverse Events

Time frame: Procedure, up to 60 days post procedure

ArmMeasureGroupValue (NUMBER)
1 - Thrombi-gel TreatmentSafety: Incidence Rate of Device-related Adverse EventsSerious2 participants
1 - Thrombi-gel TreatmentSafety: Incidence Rate of Device-related Adverse EventsNon-Serious1 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinSafety: Incidence Rate of Device-related Adverse EventsSerious0 participants
2 - Gelatin Sponge (Gelfoam) Plus ThrombinSafety: Incidence Rate of Device-related Adverse EventsNon-Serious0 participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026