CleanCision. For hospital leaders who want to gain control over the sources of surgical site infection

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CleanCision For hospital leaders who want to gain control over the sources of surgical site infection

Surgical site infection, especially in high risk abdominal and colorectal surgery, is a constant threat to patients and hospitals. PATIENTS 15 days 27.8% 29% 8 days 18% 6.8% 3 out of 20 patients undergoing high-risk abdominal surgery will develop an infection 1,2,3 MEDIAN LENGTH OF STAY 4 READMISSION 5 ICU ADMISSION 6 PATIENT SATISFACTION REOPERATION 2X RISK OF DEATH 6 With SSI Without SSI HOSPITAL $10B spent annually treating SSI 7 ~$500k annual CMS penalty per hospital 9 Average cost per SSI $19,000 5,8 Negative hospital publicity Lower SSI rates will reduce cost of care. Project the potential savings: Current SSI rate 1,2,3 15% Number of Procedures* SSI Cost / Episode 5,8 SSI Reduction 10 TOTAL SAVINGS x x x = 300 $19, o00.61 $521,550 *estimate the number of high-risk abdominal surgeries in your facility

Wound is the primary cause of SSI. Controlling it is a constant challenge. Nearly 50% of abdominal incisions are contaminated during surgery 11 No bacterial No bacterial 0% Risk of SSI 11 Bacterial Bacterial 20%+ Risk of SSI 11 Current technology does not adequately support infection control efforts to eliminate, creating critical gaps that leave patients vulnerable to infection. Incomplete skin antisepsis introduces bacteria into the incision 12 Passive wound protection can t clear invading bacteria Disruptive manual irrigation can spread 13 Prophylactic antibiotic concentrations can fall below effective levels 14

Reverse Active Cleansing Technology Continuous, consistent clearance therapy delivered during surgery Easily deployed to retract the incision, CleanCision's microfluidic membrane is connected to a surgeon-selected fluid source and suction that delivers an active clearance therapy which consistently and continuously cleanses and removes from the incision. By removing the, CleanCision helps eliminate the root cause of infection. 15

Fight Defend Intuitive Approach Designed by surgeons and infection control experts CleanCision integrates proven best practices into existing surgical workflows. Sterile irrigant solution inlet Suction Outlet Suction ring removes contaminants Fluid irrigates incision Retracts & protects widest range of incisions More complete skin antisepsis, reverses pre-existing skin 16 Active removal of 15 Reduced CFU count / inoculum of infectious at the incision 16 Combines wound irrigation and wound protection, two independently proven practices for reducing SSI 17,18 Optimizes wound healing environment, suppressing bacterial proliferation after closure 19 Powerful Results 66% 61% Reduction in Contamination 16 Reduction in SSI 10 % Contamination 50% 25% 0 35% p<0.001 12% Control CleanCision % SSI Expected 9.5% p = 0.02 CleanCision 3.7%* *Zero deep SSI

CleanCision More Control for Better Outcomes Ordering Information Prescient Surgical products can be ordered from Prescient Surgical (orders@ prescientsurgical.com) and specialty distributors. For the latest product information, visit www.prescientsurgical.com or email us at info@prescientsurgical.com. PN PRODUCT QUANTITY CC-S CleanCision Wound Retraction and Protection System SMALL (3-9 cm incision range) 4 / box CC-M CleanCision Wound Retraction and Protection System MEDIUM (7-17 cm incision range) 4 / box References: 1. Watanabe A, Kohnoe S, Shimabukuro R, et al. Risk factors associated with surgical site infection in upper and lower gastrointestinal surgery. Surg Today. 2008;38(5):404-412. 2. 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;52(3):374-379. 3. Sutton E, Miyagaki H, Bellini G, et al. Risk factors for superficial surgical site infection after elective rectal cancer resection: a multivariate analysis of 8880 patients from the American College of Surgeons National Surgical Quality Improvement Program database. J Surg Res. 2017;207:205-214. 11. Fa-Si-Oen PR, Kroeze F, Verhoef LH, Verwaest C, Roumen RM. Bacteriology of abdominal wounds in elective open colon surgery: a prospective study of 100 surgical wounds. Clin Microbiol Infect. 2005;11(2):155-157. 12. Privitera GP, Costa AL, Brusaferro S, et al. Skin antisepsis with chlorhexidine versus iodine for the prevention of surgical site infection: A systematic review and meta-analysis. Am J Infect Control. 2017;45(2):180-189. 13. Anglen JO. Wound irrigation in musculoskeletal injury. The Journal of the American Academy of Orthopaedic Surgeons. 2001;9(4):219-226. 4. 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;37(5):387-397. 14. Markantonis SL, Kostopanagiotou G, Panidis D, Smirniotis V, Voros D. Effects of blood loss and fluid volume replacement on serum and tissue gentamicin concentrations during colorectal surgery. Clin Ther. 2004;26(2):271-281. 5. Wick EC, Hirose K, Shore AD, et al. Surgical site infections and cost in obese patients undergoing colorectal surgery. Arch Surg. 2011;146(9):1068-1072. 15. Preclinical data on file at Prescient Surgical. 6. Kirkland KB, Briggs JP, Trivette SL, Wilkinson WE, Sexton DJ. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol. 1999;20(11):725-730. 7. Scott RD. The Direct Medical Costs of Healthcare-Associated Infection in US Hospitals and the Benefits of Prevention. Centers for Disease Control and Prevention; March 2009. 8. 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;72(3):243-250. 9. Rau J. Latest Hospital Injury Penalties Include Crackdown On Antibiotic-Resistant Germs. 2016; https://khn.org/news/latest-hospital-injury-penalties-include-crackdown-on-antibiotic-resistant-germs/. Accessed January 29, 2018. 10.Papaconstantinou HT, Ricciardi R, Margolin D, et al. Impact of Novel Wound Protection Device on Observed vs. Expected Surgical Site Infection Rates Following Colectomy Using the National Surgical Quality Improvement Program Risk Calculator. Paper presented at: WSA 2017 Annual Meeting2017; Scottsdale, AZ. 16. Papaconstantinou HT, Ricciardi R, Margolin DA, et al. A Novel Wound Retractor Combining Continuous Irrigation and Barrier Protection Reduces Incisional Contamination in Colorectal Surgery. World Journal of Surgery. 2018. 17. Mueller TC, Loos M, Haller B, et al. Intra-operative wound irrigation to reduce surgical site infections after abdominal surgery: a systematic review and meta-analysis. Langenbecks Arch Surg. 2015;400(2):167-181. 18. 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;69(1):21-28. 19. Suh I, Long SA, Coe J, Koehler J, Fry D, Welton ML. The Efficacy of a Novel Surgical Device in Preventing Intraoperative Wound Contamination in an In Vivo Porcine Model. J Laparoendosc Adv Surg Tech A. 2017. www.prescientsurgical.com 1585 Industrial Road San Carlos, CA 94070 650-999-0263 www.prescientsurgical.com 2018 All rights reserved Prescient Surgical. The Prescient Surgical logo and CleanCision are trademarks of Prescient Surgical. Product is subject to change without notice. MKT 1410.B For patents, visit www.prescientsurgical.com/patents