Anti-adhesive Effect of GUARDIX-SL(R) after Endoscopic Sinus Surgery

Kim, Jeong Hong; Kim, Kyung Su; Yoon, Hyun Chul; Lee, Joo Hwan; Yoon, Joo Heon; Song, Ki Jae; Park, Tae Joon

Abstract

BACKGROUND AND OBJECTIVES
Adhesion after sinus surgery represents a potential source of surgical failure. GUARDIX-SL(R) which is composed of sodium hyaluronate and sodium carboxymethyl cellulose, is an effective agent that can be used as a surgical adjuvant to decrease adhesion in the abdominal surgery. Therefore, we evaluated the clinical efficacy and safety of the GUARDIX-SL(R) for the prevention of adhesion after endoscopic sinus surgery. SUBJECTS AND METHOD: This study was randomized and double-blinded. At the completion of endoscopic sinus surgery, 6 mL GUARDIX-SL(R) was applied on Merocel(R) and repeatedly applied on the middle meatus after removal of Merocel(R) (n=22). As a control group, normal saline was applied instead of GUARDIX-SL(R)(n=22). Endoscopic examination was performed at 3 days, 1 week, 2 weeks, and 4 weeks, postoperatively. Adhesion formation was graded as G0-G4, and CT scoring was also performed. RESULTS: The rate of adhesion formation was the highest at 2 weeks after operation and was significantly lower in the GUARDIX-SL(R) treated group than in the control throughout the period of observation. The cases were divided into 3 groups according to the CT scores at 2 weeks after operation: The groups with the GUARDIX-SL(R) treatment also showed lower adhesion formation than the control. The safety profile of the patients was normal at 4 weeks postoperatively. CONCLUSION: The results suggest that GUARDIX-SL(R) may be an efficacious and safe material in decreasing the incidence of adhesion after sinus surgery.