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 (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.