Anti-adhesive Effect and Safety of Sodium Hyaluronate and Sodium Carboxymethyl Cellulose Solution in Thyroid Surgery

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 (p0.066). 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. [Asian J Surg 2010;33(425-30]Metwally M, 2008, CURR OPIN OBSTET GYN, V20, P345Zeng QQ, 2007, WORLD J SURG, V31, P2125, DOI 10.1007/s00268-007-9242-9Fazio VW, 2006, DIS COLON RECTUM, V49, P1, DOI 10.1007/s10350-005-0268-5Kusunoki M, 2005, SURG TODAY, V35, P940, DOI 10.1007/s00595-005-3061-0Kutlay J, 2004, WORLD J SURG, V28, P662, DOI 10.1007/s00268-004-6825-6Beck DE, 2003, DIS COLON RECTUM, V46, P1310, DOI 10.1097/01.DCR.0000089117.62296.E4Thompson LDR, 2001, CANCER, V91, P505Hellebrekers BWJ, 2000, HUM REPROD, V15, P1358Osada H, 1999, J INT MED RES, V27, P292Chao TC, 1997, WORLD J SURG, V21, P644Becker JM, 1996, J AM COLL SURGEONS, V183, P297SHAHA AR, 1995, SURGERY, V118, P1131BAR A, 1995, FOOD CHEM TOXICOL, V33, P901LIVOLSI VA, 1992, AM J CLIN PATHOL, V97, P426AYYASH K, 1991, ACTA CHIR-EUR J SURG, V157, P113FREDERICKS CM, 1986, AM J OBSTET GYNECOL, V155, P667KRISTOFFERSSON A, 1986, BRIT J SURG, V73, P121CARCANGIU ML, 1985, CANCER, V55, P805ELKINS TE, 1984, FERTIL STERIL, V41, P926MAZZAFERRI EL, 1981, AM J MED, V70, P511TOLLEFSE.HR, 1972, AM J SURG, V124, P468