Anti-adhesive Effect and Safety of Sodium Hyaluronate and Sodium Carboxymethyl Cellulose Solution in Thyroid Surgery
Accepted 17 March 2010.
Objective
A number of researchers have suggested the use of sodium hyaluronate carboxymethyl cellulose (HA-CMC) membrane for preventing postoperative adhesion. This study evaluated the anti-adhesive effect and safety of a newly developed HA-CMC solution in thyroidectomy.
Methods
Seventy-four patients who underwent thyroidectomy were prospectively randomized. In the study group of 38 patients, 5 mL HA-CMC solution was applied to the operative field after thyroidectomy. The subjects were asked about adhesive symptoms using a four-item questionnaire at 2 weeks, 2 months and 6 months after surgery. In addition, three items on the appearance of neck wrinkles and scars were evaluated by a physician. Each item was scored from 0 to 10.
Results
The mean (± standard deviation) total adhesion score at each visit was 15.22 ± 8.99, 10.42 ± 8.41, and 7.24 ± 5.83 for the control group and 19.29 ± 9.71, 9.46 ± 5.71, and 6.03 ± 4.32 for the study group. Total adhesion scores for both groups decreased with time (p < 0.001), but no significant differences were noted between the two groups (p > 0.066). There were no complications related to the HA-CMC solution.
Conclusion
The HA-CMC solution did not decrease subjective or objective postoperative adhesion in patients undergoing thyroid surgery, although it was biologically safe.
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aDepartment of Surgery, St. Vincent's Hospital, The Catholic University of Korea, Gyeonggi-do, Seoul, Korea
bDepartment of Surgery, Seoul National University College of Medicine, Seoul, Korea
cDepartment of Surgery, Korea University College of Medicine, Seoul, Korea
dDepartment of Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
eDepartment of Surgery, Seoul National University Cancer Research Institute, Seoul, Korea
Department of Surgery, Kyung Hee University School of Medicine, Seoul, Korea
Address correspondence and reprint requests to Dr Yeo-Kyu Youn, Department of Surgery, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea
ABSTRACT