D-PLEX 312 - Safety and Efficacy of D-PLEX in the Prevention of Post Abdominal Surgery Incisional Infection (SHIELD II) (D-PLEX312)

June 16, 2026 updated by: PolyPid Ltd.

D-PLEX 312 - Phase III, Prospective, Multinational, Multicenter, Randomized, Controlled, Two-arm, Double Blind Study to Assess Efficacy and Safety of D-PLEX In Prevention of Post Abdominal Surgery Incisional Infection (SHIELD II)

Phase III, Prospective, Multinational, Multicenter, Randomized, Controlled, Two-arm, Double Blind Study to Assess Efficacy and Safety of D-PLEX Administered Concomitantly with the Standard of Care (SoC), Compared to a SoC Treated Control Arm, in Prevention of Post Abdominal Surgery Incisional Infection.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

D-PLEX is a new formulation of extended controlled release of Doxycycline in the applied area for about 30 days. This study is aimed to assess the safety and efficacy of D-PLEX in prevention of post abdominal surgery incisional infection.

The study population includes male and female, 18 years old and above at screening, undergoing an elective colorectal surgery involving colon or rectal resection, with or without a stoma formation, that includes at least 1 incision that is > 20cm (target incision).

Eligible and willing subjects will be randomly allocated into 2 blinded study arms, either to the investigational arm (D-PLEX + SoC) or to the control arm (SoC only) in a 1:1 ratio. Subjects will be stratified by type of prophylactic SoC (IV antibiotic only, IV antibiotic with mechanical bowel preparation or IV antibiotic with oral antibiotics combined with mechanical bowel preparation) and by region (US versus Europe + Israel).

D-PLEX will be applied during the surgery at the final stage of incision closure. All patients will be followed up for additional 5 visits over 2 months, for safety and incisional wound assessment. This will include blood tests for hematology and chemistry as well as physician's assessment of the incisional wound.

Study Type

Interventional

Enrollment (Actual)

975

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

      • Banja Luka, Bosnia and Herzegovina, 78000
        • University Clinical Centre of the Republic of Srpska
      • Tuzla, Bosnia and Herzegovina, 75000
        • University Clinical Center Tuzla
      • Zenica, Bosnia and Herzegovina, 72000
        • Cantonal Hospital Zenica
      • Tbilisi, Georgia, 0114
        • LTD New Hospitals
      • Tbilisi, Georgia, 0102
        • LLC American Hospital Network
      • Tbilisi, Georgia, 0112
        • LTD "Israeli - Georgian Medical Research Clinic Healthycore"
      • Tbilisi, Georgia, 0186
        • LTD Multiprofile Clinic Consillium Medulla
      • Erlangen, Germany, 91054
        • University Hospital Erlangen
      • Münster, Germany, 48149
        • University of Muenster
      • Baja, Hungary, 6500
        • Bajai Szent Rokus Korhaz, Sebeszeti Osztaly
      • Budapest, Hungary, 1145
        • Uzsoki Utcai Kórház, Sebészeti Osztály
      • Eger, Hungary, 3300
        • Heves Varmegyei Markhot Ferenc Oktatokorhaz es Rendelointezet Sebeszeti es Ersebeszeti osztaly
      • Gyöngyös, Hungary, 3200
        • Bugát Pál Kórház, Gasztroenterológia - Sebészet
      • Kecskemét, Hungary, 6000
        • Bács-Kiskun Megyei Kórház
      • Kistarcsa, Hungary, 2143
        • Pest Megyei Flór Ferenc Kórház Sebészeti Osztály
      • Nyíregyháza, Hungary, 4400
        • Szabolcs-Szatmar-Bereg Varmegyei Korhazak es Egyetemi Oktatokorhaz, Josa Andras Oktatokorhaz, Sebeszeti Osztaly
      • Szeged, Hungary, 6725
        • University of Szeged, Faculty of Medicine, Dep.of Surgery
      • Székesfehérvár, Hungary, 8000
        • Fejer-County Saint George University Teaching Hospital, Department of Surgery
      • Drogheda, Ireland, A92 VW28
        • Our Lady of Lourdes Hospital
      • Beersheba, Israel, 8457108
        • Soroka Medical Center
      • Haifa, Israel, 3339419
        • Bnai Zion Medical Center
      • Haifa, Israel, 3436212
        • Carmel Medical Center
      • Jerusalem, Israel, 9372212
        • Shaare Zedek Medical Center
      • Nahariya, Israel, 2210001
        • Galilee Medical Center
      • Ramat Gan, Israel, 5262000
        • Sheba Medical Center
      • Rehovot, Israel, 7661041
        • Kaplan Medical Center
      • Ẕerifin, Israel, 70300
        • Assaf Harofeh Medical Center
      • Chisinau, Moldova, MD2004
        • IMSP Institutul de Medicina Urgenta
      • Chisinau, Moldova, MD2025
        • IMSP Clinical republican Hospital "Timofei Mosneaga"
      • Chisinau, Moldova, MD2025
        • IMSP Institutul of Oncologic
      • Chisinau, Moldova, MD2025
        • IMSP Spitalul Clinic Republican "Timofei Mosneaga"
      • Chisinau, Moldova, MD2038
        • IMSP Spitalul Clinic Municipal "Gheorghe Paladi"
      • Chisinau, Moldova, MD2068
        • IMSP Spitalul Clinic Municipal "Sfanta Treime"
      • Prilep, North Macedonia, 7500
        • PHI General Hospital "Borka Taleski" Prilep
      • Skopje, North Macedonia, 1000
        • PHI University Clinic for digestive Surgery
      • Skopje, North Macedonia, 1000
        • PHI University Clinic for Surgical Diseases "st.Naum Ohridski - Skopje"
      • Skopje, North Macedonia, 2000
        • PHI Clinical Hospital - Shtip
      • Strumica, North Macedonia, 2400
        • PHI General Hospital - Strumica
      • Lodz, Poland, 91-034
        • Centrum Medyczne Med-Gastr
      • Ostrów Mazowiecka, Poland, 07-300
        • Szpital Powiatowy im. Marii Skłodowskiej - Curie w Ostrowie Mazowieckiej SPZZOZ
      • Aveiro, Portugal, 3810-164
        • Unidade Local de Saúde da Região de Aveiro E. P. E.
      • Braga, Portugal, 4710-243
        • Centro Clinico Academico de Braga Associação - Hospital de Braga
      • Guarda, Portugal, 6300-749
        • Unidade de Saúde Local da Guarda
      • Brasov, Romania, 500388
        • Sf. Constantin Hospital
      • Craiova, Romania, 200642
        • Spitalul Clinic Judetean de Urgenta Craiova, Sectia Cbirurgie Generala II
      • Craiova, Romania, 200642
        • Spitalul Clinic Judetean de Urgenta Craiova, Sectia Chirurgie Generala III
      • Timișoara, Romania, 300723
        • Spitalul Clinic JudeIean de Urgenta "Pius Brinzeu", Sectia Chirurgie Generala II
      • Târgu Mureş, Romania, 540103
        • Mures County Clinical Hospital
      • Belgrade, Serbia, 11000
        • First Surgical Clinic
      • Kamenitz, Serbia, 21204
        • Oncology Institute of Vojvodina
      • Niš, Serbia, 18000
        • UCC Nis
      • Sremska Mitrovica, Serbia, 22000
        • General Hospital Sremska Mitrovica
      • Valjevo, Serbia, 14000
        • Health Center Valjevo
    • Georgia
      • Augusta, Georgia, United States, 30912
        • Augusta Univeristy
    • Louisiana
      • New Orleans, Louisiana, United States, 70121
        • Ochsner Medical Center
    • Missouri
      • St Louis, Missouri, United States, 63110
        • Washington University School of Medicine
    • Pennsylvania
      • Hershey, Pennsylvania, United States, 17033
        • Penn State Health Milton S Hershey Medical Center
    • Texas
      • Dallas, Texas, United States, 75246
        • Baylor University Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 99 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Subjects undergoing an elective colorectal surgery involving resection, with or without a stoma formation, that includes at least 1 abdominal incision that is >20cm (target incision).
  2. Subjects are preoperative hemodynamically stable. (BP≤180/110 and >90/60 mmHg, and HR≤120 and >60 bpm, and temperature ≤37.50C and >35.50C).
  3. Male or non-pregnant female.
  4. Female of child-bearing potential should have a negative pregnancy test (serum or urine dipstick) prior to index procedure.
  5. Subjects' age 18 years old and above at screening.
  6. Subjects who sign the written Informed Consent Form.
  7. Subjects who are willing and able to participate and meet all study requirements.
  8. Survival expectancy of at least sixty days post randomization.

Exclusion criteria:

  1. Subjects with suspected/diagnosed intestinal perforation, intra-abdominal abscess, or any emergency/urgent colorectal surgery with acute intestinal obstruction (ex. toxic colitis, ileus/sub-ileus, megacolon, diverticulitis, volvulus, etc.)
  2. Subjects who underwent an intra-abdominal surgery within the last six months prior to randomization.
  3. Subjects with any preoperative active infection or who are receiving any antibiotic therapy in the past one week prior to randomization, excluding pre-operative prophylaxis or antibiotics for the treatment of the disease that is the indication for surgery.
  4. Subjects undergoing concomitant major procedures in addition to the colorectal resection. Female sterilization surgeries (i.e. salpingo-oophorectomy etc.), involvement of a small bowel procedure or cholecystectomy may be allowed, pending an advanced consultation and approval from the Sponsor.
  5. Subjects who received any anti-cancer treatment within the last four weeks of surgery.
  6. Subjects who received radiation for colorectal cancer to the abdomen and/or pelvis area, within the last four weeks of the planned abdominal surgery.
  7. Subjects who received oral or IV Doxycycline or Tetracycline family antibiotics during the past four weeks prior to randomization.
  8. Subjects with known allergy to Doxycycline and/or to the tetracycline family of drugs or to the D-PLEX's excipients.
  9. Subjects with known allergies to more than three substances.
  10. Subjects with history of severe allergic reaction to any substance, having required treatment with intravenous steroids/intramuscular epinephrine, or who in the opinion of the PI is at high risk of developing severe allergic reactions.
  11. Uncontrolled medical condition.
  12. Subjects who underwent any abdominal surgery and current planned index surgery involves re-opening the scar of a prior abdominal surgery performed within the last three years.
  13. Any subject with an active malignancy or with malignancy that has not been in complete clinical remission and without maintenance chemo or immunotherapy for at least three years.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: Standard of Care
The SoC for prophylactic antibiotic treatment is based on international guidelines
prophylactic, pre-operation per institution guidelines
Experimental: D-PLEX+SoC
D-PLEX is provided as an adjunct to the SoC treatment
prophylactic, pre-operation per institution guidelines
D-PLEX is a new formulation of extended release of Doxycycline.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Infection Rate as Measured by the Percentage of Subjects With SSI Event in the Target Incision Within 30 Days Post Index Surgery or Re-interventions or Death [for Any Reason] in the Population of Subjects With Target Incision Length >20 cm
Time Frame: By day 30 post surgery
The primary analysis is based on a composite treatment-failure (Yes/No) variable, indicating if a subject had at least one treatment-failure event, defined as follows: SSI, occurring within 30 days post abdominal surgery and determined by a blinded and independent adjudication committee, death (from any reason) or re-intervention at the target incision site within 30 days post surgery will be considered a treatment failure for the primary ITT analysis.
By day 30 post surgery

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The Percentage of Subjects With at Least One SSI Event in the Target Incision
Time Frame: By day 30 post surgery
Infection rate as measured by the proportion of subjects with at least one abdominal incisional infection event, occurring within 30 days post abdominal (index) surgery and determined by a blinded and independent adjudication committee. [abdominal incisional infection is defined as Deep Incisional Surgical Site Infection (DSSI) and/or Superficial Incisional Surgical Site Infection (SSSI)].
By day 30 post surgery
Infection Rate as Measured by the Percentage of Subjects With SSI Event in the Target Incision Within 30 Days Post Index Surgery or Re-interventions or Death [for Any Reason] in the Population of Subjects With Target Incision Length >7 cm
Time Frame: 30 days post surgery
The primary analysis is based on a composite treatment-failure (Yes/No) variable, indicating if a subject had at least one treatment-failure event, defined as follows: SSI, occurring within 30 days post abdominal surgery and determined by a blinded and independent adjudication committee, and target incision length > 7 cm, death (from any reason) or re-intervention at the target incision site within 30 days post surgery will be considered a treatment failure.
30 days post surgery
Percentage of Subjects With at Least 1 Score of ASEPSIS> 20, Within 30 Days Post Abdominal (Index) Surgery
Time Frame: 30 days post surgery
ASEPSIS (Additional Treatment, Serous Discharge, Erythema, Purulent Exudates, Separation of Deep Tissue, Isolation of Bacteria, Stay as In Patient) is an acronym of wound assessment and treatment parameters, which provides numerically score during an inspection of the surgical site. The final score is being interpreted to severity of wound appearance and the clinical consequences of the infection.
30 days post surgery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 15, 2020

Primary Completion (Actual)

April 14, 2025

Study Completion (Actual)

May 10, 2025

Study Registration Dates

First Submitted

May 27, 2020

First Submitted That Met QC Criteria

May 27, 2020

First Posted (Actual)

June 2, 2020

Study Record Updates

Last Update Posted (Actual)

July 13, 2026

Last Update Submitted That Met QC Criteria

June 16, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • D-PLEX 312

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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