BIOlogic Augmented Repair of Complex Anal Fistula Using Acellular Matrix and/or Autologous Platelet-rich Plasma

NCT ID: NCT05805449

Last Updated: 2023-04-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

250 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-02-21

Study Completion Date

2026-03-31

Brief Summary

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The purpose of this study is to compare the clinical effectiveness of augmenting surgical repair of complex anal fistula using autologous PRP and/or micronized acellular porcine urinary bladder matrix (UBM) to usual surgical care alone to prevent fistula recurrence or improve HRQoL, to compare the effects of augmenting surgical repair of complex anal fistula using autologous PRP and/or micronized acellular porcine urinary bladder matrix on early postoperative pain and fecal continence and to assess the cost utility of augmented complex fistula repair relative to usual surgical care

Detailed Description

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Conditions

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Anal Fistula

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Surgery

Control patients will receive usual standard of care surgical repair of their complex fistula by The ligation of intersphincteric tract (LIFT) or advancement flap technique without any biologic adjunct.

Group Type SHAM_COMPARATOR

Surgery

Intervention Type PROCEDURE

Control patients will receive usual standard of care surgical repair of their complex fistula by LIFT or advancement flap technique without any biologic adjunct.

Surgery plus platelet-rich plasma (PRP)

Group Type EXPERIMENTAL

Surgery

Intervention Type PROCEDURE

Control patients will receive usual standard of care surgical repair of their complex fistula by LIFT or advancement flap technique without any biologic adjunct.

Platelet-rich plasma (PRP)

Intervention Type OTHER

Participants will have 40-50cc of peripheral whole blood drawn into a syringe pre-loaded with acid citrate dextrose (ACD) anticoagulant and concentrated PRP harvested by double centrifugation technique using the manufacturer's kit and benchtop centrifuge. This typically yields 5-8cc of PRP that is 18-times more concentrated than baseline.

Surgery plus matrix

Group Type EXPERIMENTAL

Surgery

Intervention Type PROCEDURE

Control patients will receive usual standard of care surgical repair of their complex fistula by LIFT or advancement flap technique without any biologic adjunct.

Matrix

Intervention Type DEVICE

Participants will receive 200g of "paste" matrix and 200g injected at the following sites: the internal opening closure site at level of the sphincter muscle, within the walls of the fistula tract along its length, and within the tissue of an advancement flap particularly at areas of tissue apposition.

Surgery plus PRP plus matrix material

Group Type EXPERIMENTAL

Surgery

Intervention Type PROCEDURE

Control patients will receive usual standard of care surgical repair of their complex fistula by LIFT or advancement flap technique without any biologic adjunct.

Platelet-rich plasma (PRP)

Intervention Type OTHER

Participants will have 40-50cc of peripheral whole blood drawn into a syringe pre-loaded with acid citrate dextrose (ACD) anticoagulant and concentrated PRP harvested by double centrifugation technique using the manufacturer's kit and benchtop centrifuge. This typically yields 5-8cc of PRP that is 18-times more concentrated than baseline.

Matrix

Intervention Type DEVICE

Participants will receive 200g of "paste" matrix and 200g injected at the following sites: the internal opening closure site at level of the sphincter muscle, within the walls of the fistula tract along its length, and within the tissue of an advancement flap particularly at areas of tissue apposition.

Interventions

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Surgery

Control patients will receive usual standard of care surgical repair of their complex fistula by LIFT or advancement flap technique without any biologic adjunct.

Intervention Type PROCEDURE

Platelet-rich plasma (PRP)

Participants will have 40-50cc of peripheral whole blood drawn into a syringe pre-loaded with acid citrate dextrose (ACD) anticoagulant and concentrated PRP harvested by double centrifugation technique using the manufacturer's kit and benchtop centrifuge. This typically yields 5-8cc of PRP that is 18-times more concentrated than baseline.

Intervention Type OTHER

Matrix

Participants will receive 200g of "paste" matrix and 200g injected at the following sites: the internal opening closure site at level of the sphincter muscle, within the walls of the fistula tract along its length, and within the tissue of an advancement flap particularly at areas of tissue apposition.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* complex cryptoglandular transsphincteric anal fistula undergoing surgical repair by LIFT or advancement flap procedure
* English or Spanish speaking and capable of providing informed consent
* Willing to undergo temporary anal seton drainage for requisite time prior to repair
* Participating surgeons will only be eligible if they perform at least 3 repair procedures/year

Exclusion Criteria

* Unable to reliably complete follow up for 12 months postoperatively
* Primary platelet disorders
* Thrombocytopenia \< 150 plt/microliter
* Inability to stop anti-platelet agent \> 5 days preoperatively
* Fistula associated with inflammatory bowel disease (IBD), malignancy or pelvic/perineal radiation
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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CENTER FOR CLINICAL AND TRANSLATIONAL SCIENCES

UNKNOWN

Sponsor Role collaborator

The University of Texas Health Science Center, Houston

OTHER

Sponsor Role lead

Responsible Party

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Jeff Van Eps, MD

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jeffrey L Van Eps, MD

Role: PRINCIPAL_INVESTIGATOR

The University of Texas Health Science Center, Houston

Locations

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The University of Texas Health Science Center at Houston

Houston, Texas, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Jeffrey L Van Eps, MD

Role: CONTACT

713-486-4600

Angielyn Rivera

Role: CONTACT

713-416-1350

Facility Contacts

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Jeffrey L Van Eps, MD

Role: primary

713-486-4600

Angielyn Rivera

Role: backup

713-416-1350

Other Identifiers

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HSC-MS-22-0759

Identifier Type: -

Identifier Source: org_study_id

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