Prospective, Randomized, Parallel-arm Clinical Trial of CleanCision or Alexis O in Elective Colorectal Surgery

NCT ID: NCT03816995

Last Updated: 2025-08-06

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

702 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-02-12

Study Completion Date

2023-08-18

Brief Summary

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Surgical site infection (SSI) remains a problem in colorectal surgery. Strategies to reduce the incidence of SSI following colorectal surgery are important to improve overall patient outcomes, reduce healthcare-associated costs and provide value-based healthcare to surgical patients.

Preventing contamination of the wound through the use of barrier wound protectors or intraoperative wound irrigation has shown significant promise individually and is an ongoing focus to reduce wound infections SSI.

Detailed Description

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Surgical site infection (SSI) remains a persistent and morbid problem in colorectal surgery with published rates ranging from 7 to 25%. The negative outcomes of SSI are well reported and include a significant increase in morbidity, length of hospital stay, readmissions and healthcare-associated cost. Therefore, strategies to reduce the incidence of SSI following colorectal surgery are important to improve overall patient outcomes, reduce healthcare-associated costs and provide value-based healthcare to surgical patients.

Key to the pathogenesis of SSI is the degree of bacterial contamination of the surgical wound. Preventing contamination of the wound or reducing the bacterial load through the use of barrier wound protectors or intraoperative wound irrigation has shown significant promise individually and is an ongoing strategic focus to reduce wound infections after surgery.

The usage of intraoperative wound irrigation has been shown to significantly reduce the risk of SSI via multiple RTC. A surgical device that combines continuous wound irrigation and barrier protection will have an important SSI prevention advantage.

CleanCision is a recently developed apparatus that serves this purpose and was found to reduce bacterial wound contamination in preclinical and clinical trials.

This study aims to investigate the effect of using CleanCision wound protector on the rates of postoperative Surgical Site Infections in comparison to the current wound protector (Alexis O) being used at our institute.

Conditions

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Colorectal Surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Alexis O Wound Protector

Participants will undergo standard surgical procedure using the Alexis O wound protector.

Group Type ACTIVE_COMPARATOR

Alexis O Wound Protector

Intervention Type DEVICE

wound retraction

CleanCision Wound Protector

Participants will undergo standard surgical procedure using the CleanCision Wound Retraction and Protection System

Group Type EXPERIMENTAL

CleanCision Wound Retraction and Protection System

Intervention Type DEVICE

wound retraction and irrigation

Interventions

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CleanCision Wound Retraction and Protection System

wound retraction and irrigation

Intervention Type DEVICE

Alexis O Wound Protector

wound retraction

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Patients 18 years old and above.
2. Elective colorectal surgery with a planned resection including open or laparoscopic surgeries.
3. Clean -contaminated, contaminated and dirty wounds per the definition above.
4. Patients undergoing Standard of care SSI reduction bundle including Prophylactic AB and mechanical bowel preparation.
5. Anticipated incision length of 3-17 cm

Exclusion Criteria

1. Patients younger than 18 years old.
2. Patients with a preexisting stoma.
3. Patients with prior laparotomy within 15 days.
4. Patients with an active infection or systemic antibiotic therapy within 1 week prior to surgery with the exception of preoperative antimicrobial prophylaxis.
5. Emergent/ urgent surgery.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Prescient Surgical

INDUSTRY

Sponsor Role collaborator

Scott Steele

OTHER

Sponsor Role lead

Responsible Party

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Scott Steele

President, Main Campus Submarket

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Scott Steele, MD

Role: PRINCIPAL_INVESTIGATOR

The Cleveland Clinic

Locations

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Cleveland Clinic Main Campus

Cleveland, Ohio, United States

Site Status

Countries

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United States

References

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Walz JM, Paterson CA, Seligowski JM, Heard SO. Surgical site infection following bowel surgery: a retrospective analysis of 1446 patients. Arch Surg. 2006 Oct;141(10):1014-8; discussion 1018. doi: 10.1001/archsurg.141.10.1014.

Reference Type BACKGROUND
PMID: 17043280 (View on PubMed)

Smith RL, Bohl JK, McElearney ST, Friel CM, Barclay MM, Sawyer RG, Foley EF. Wound infection after elective colorectal resection. Ann Surg. 2004 May;239(5):599-605; discussion 605-7. doi: 10.1097/01.sla.0000124292.21605.99.

Reference Type BACKGROUND
PMID: 15082963 (View on PubMed)

Konishi T, Watanabe T, Kishimoto J, Nagawa H. Elective colon and rectal surgery differ in risk factors for wound infection: results of prospective surveillance. Ann Surg. 2006 Nov;244(5):758-63. doi: 10.1097/01.sla.0000219017.78611.49.

Reference Type BACKGROUND
PMID: 17060769 (View on PubMed)

de Oliveira AC, Ciosak SI, Ferraz EM, Grinbaum RS. Surgical site infection in patients submitted to digestive surgery: risk prediction and the NNIS risk index. Am J Infect Control. 2006 May;34(4):201-7. doi: 10.1016/j.ajic.2005.12.011.

Reference Type BACKGROUND
PMID: 16679177 (View on PubMed)

Fujii S, Tsukamoto M, Fukushima Y, Shimada R, Okamoto K, Tsuchiya T, Nozawa K, Matsuda K, Hashiguchi Y. Systematic review of laparoscopic vs open surgery for colorectal cancer in elderly patients. World J Gastrointest Oncol. 2016 Jul 15;8(7):573-82. doi: 10.4251/wjgo.v8.i7.573.

Reference Type BACKGROUND
PMID: 27559437 (View on PubMed)

Serra-Aracil X, Garcia-Domingo MI, Pares D, Espin-Basany E, Biondo S, Guirao X, Orrego C, Sitges-Serra A. Surgical site infection in elective operations for colorectal cancer after the application of preventive measures. Arch Surg. 2011 May;146(5):606-12. doi: 10.1001/archsurg.2011.90.

Reference Type BACKGROUND
PMID: 21576613 (View on PubMed)

de Lissovoy G, Fraeman K, Hutchins V, Murphy D, Song D, Vaughn BB. Surgical site infection: incidence and impact on hospital utilization and treatment costs. Am J Infect Control. 2009 Jun;37(5):387-397. doi: 10.1016/j.ajic.2008.12.010. Epub 2009 Apr 23.

Reference Type BACKGROUND
PMID: 19398246 (View on PubMed)

Tanner J, Khan D, Aplin C, Ball J, Thomas M, Bankart J. Post-discharge surveillance to identify colorectal surgical site infection rates and related costs. J Hosp Infect. 2009 Jul;72(3):243-50. doi: 10.1016/j.jhin.2009.03.021. Epub 2009 May 15.

Reference Type BACKGROUND
PMID: 19446918 (View on PubMed)

Wick EC, Vogel JD, Church JM, Remzi F, Fazio VW. Surgical site infections in a "high outlier" institution: are colorectal surgeons to blame? Dis Colon Rectum. 2009 Mar;52(3):374-9. doi: 10.1007/DCR.0b013e31819a5e45.

Reference Type BACKGROUND
PMID: 19333034 (View on PubMed)

Gorgun E, Rencuzogullari A, Ozben V, Stocchi L, Fraser T, Benlice C, Hull T. An Effective Bundled Approach Reduces Surgical Site Infections in a High-Outlier Colorectal Unit. Dis Colon Rectum. 2018 Jan;61(1):89-98. doi: 10.1097/DCR.0000000000000929.

Reference Type BACKGROUND
PMID: 29215475 (View on PubMed)

Sajid MS, Rathore MA, Sains P, Singh KK. A systematic review of clinical effectiveness of wound edge protector devices in reducing surgical site infections in patients undergoing abdominal surgery. Updates Surg. 2017 Mar;69(1):21-28. doi: 10.1007/s13304-017-0415-2. Epub 2017 Jan 25.

Reference Type BACKGROUND
PMID: 28124278 (View on PubMed)

Ruiz-Tovar J, Santos J, Arroyo A, Llavero C, Armananzas L, Lopez-Delgado A, Frangi A, Alcaide MJ, Candela F, Calpena R. Effect of peritoneal lavage with clindamycin-gentamicin solution on infections after elective colorectal cancer surgery. J Am Coll Surg. 2012 Feb;214(2):202-7. doi: 10.1016/j.jamcollsurg.2011.10.014.

Reference Type BACKGROUND
PMID: 22265220 (View on PubMed)

Mueller TC, Loos M, Haller B, Mihaljevic AL, Nitsche U, Wilhelm D, Friess H, Kleeff J, Bader FG. Intra-operative wound irrigation to reduce surgical site infections after abdominal surgery: a systematic review and meta-analysis. Langenbecks Arch Surg. 2015 Feb;400(2):167-81. doi: 10.1007/s00423-015-1279-x. Epub 2015 Feb 14.

Reference Type BACKGROUND
PMID: 25681239 (View on PubMed)

Solomkin J, Gastmeier P, Bischoff P, Latif A, Berenholtz S, Egger M, Allegranzi B. WHO Guidelines to prevent surgical site infections-Authors' reply. Lancet Infect Dis. 2017 Mar;17(3):262-264. doi: 10.1016/S1473-3099(17)30081-6. Epub 2017 Feb 23. No abstract available.

Reference Type BACKGROUND
PMID: 28244389 (View on PubMed)

Papaconstantinou HT, Ricciardi R, Margolin DA, Bergamaschi R, Moesinger RC, Lichliter WE, Birnbaum EH. A Novel Wound Retractor Combining Continuous Irrigation and Barrier Protection Reduces Incisional Contamination in Colorectal Surgery. World J Surg. 2018 Sep;42(9):3000-3007. doi: 10.1007/s00268-018-4568-z.

Reference Type BACKGROUND
PMID: 29523908 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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18-1346

Identifier Type: -

Identifier Source: org_study_id

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