J Korean Foot Ankle Soc.  2017 Dec;21(4):151-155. 10.14193/jkfas.2017.21.4.151.

Clinical Application and Effects of Sodium Hyaluronate-Carboxymethylcellulose (Guardix®) in Surgery of Ankle Fractures

Affiliations
  • 1Department of Orthopaedic Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea. kiga9@hallym.or.kr

Abstract

PURPOSE
Reducing tenderness or pain on the ankle joint and improving the range of motion are thought to be possible using hyaluronate-based anti-adhesive agents. On the other hand, there are more aspects to be studied regarding the incidence of complications, such as resting pain, tenderness, and stiffness, after surgery. Therefore, the aim of this study was to prove the effectiveness of the agents after ankle fracture surgery.
MATERIALS AND METHODS
Patients, who underwent open reduction and internal fixation surgery due to ankle joint fractures from June 2015 to May 2016, were studied prospectively. Thirty patients of them received a Guardix® injection during their surgeries and were included in the injection group. The other 30 patients were included in the control group. Postoperatively, tenderness on the scar, a delay in wound healing, and the active range of motion were evaluated at 2, 6, and 12 weeks after surgery.
RESULTS
A significant difference in tenderness on the scar was observed 2 weeks after surgery. On the other hand, there was no significant difference at 6 and 12 weeks after the surgery. The agent-using group showed a 6.7% delay in wound healing and a 93.3% non-delaying. In the non-using group, the delay was 63.3%, while non-delay was 36.7% (p < 0.001). The group that underwent Guardix® usage showed an effective result in the visual analogue scale, which was statistically significant (p < 0.001). The result at 6 and 12 weeks after surgery showed a significant difference.
CONCLUSION
Improvement was observed in the patients who underwent a Guardix® injection, regarding the range of motion, visual analog scale, and healing of the wound postoperatively.

Keyword

Adhesion; Guardix®; Sodium hyaluronate-carboxymethylcellulose; Ankle joint fracture; Range of motion

MeSH Terms

Ankle Fractures*
Ankle Joint
Ankle*
Cicatrix
Hand
Humans
Incidence
Prospective Studies
Range of Motion, Articular
Sodium*
Visual Analog Scale
Wound Healing
Wounds and Injuries
Sodium

Reference

11.Cimino W., Ichtertz D., Slabaugh P. Early mobilization of ankle fractures after open reduction and internal fixation1 Clin Orthop Relat Res1. 1991. 267:152–61.
21.Finsen V., Saetermo R., Kibsgaard L., Farran K., Engebretsen L., Bolz KD, et al. Early postoperative weight-bearing and muscle activity in patients who have a fracture of the ankle1 J Bone Joint Surg Am1. 1989. 71:23–71.
31.Burwell HN., Charnley AD. The treatment of displaced fractures at the ankle by rigid internal fixation and early joint movement1 J Bone Joint Surg Br1. 1965. 47:634–601.
41.Song HJ., Kim JW., Park JS., Kim YS., Choi YS., Kim BG, et al. Effects of three different types of anti-adhesive agents in a rat abdominal wall defect model1 J Korean Surg Soc1. 2009. 77:7–141.
51.Dijkstra FR., Nieuwenhuijzen M., Reijnen MM., van Goor H. Recent clinical developments in pathophysiology, epidemiology, diagnosis and treatment of intra-abdominal adhesions1 Scand J Gastroenterol Suppl1. 2000. 232:52–91.
61.Rout UK., Diamond MP. Role of plasminogen activators during healing after uterine serosal lesioning in the rat1 Fertil Steril1. 2003. 79:138–451.
71.Holmdahl L., Ivarsson ML. The role of cytokines, coagulation, and fibrinolysis in peritoneal tissue repair1 Eur J Surg1. 1999. 165:1012–91.
81.Herrick SE., Mutsaers SE., Ozua P., Sulaiman H., Omer A., Boulos P, et al. Human peritoneal adhesions are highly cellular, innervated, and vascularized1 J Pathol1. 2000. 192:67–721.
91.Kim JH., Lee JH., Yoon JH., Chang JH., Bae JH., Kim KS. Antiad-hesive effect of the mixed solution of sodium hyaluronate and sodium carboxymethylcellulose after endoscopic sinus surgery1 Am J Rhinol1. 2007. 21:95–91.
101.Ellis H., Moran BJ., Thompson JN., Parker MC., Wilson MS., Menzies D, et al. Adhesion-related hospital readmissions after abdominal and pelvic surgery: a retrospective cohort study1 Lancet1. 1999. 353:1476–801.
111.Lower AM., Hawthorn RJ., Ellis H., O’Brien F., Buchan S., Crowe AM. The impact of adhesions on hospital readmissions over ten years after 8849 open gynaecological operations: an assessment from the Surgical and Clinical Adhesions Research Study1 BJOG1. 2000. 107:855–621.
121.Shim HS., Lee YW., Lee YM., Oh YH., Kwon SW., Kim JH, et al. Evaluation of resorbable materials for preventing surgical adhesion on rat experiment1 J Korean Surg Soc1. 2002. 63:179–861.
131.Hooker GD., Taylor BM., Driman DK. Prevention of adhesion formation with use of sodium hyaluronate-based bioresorbable membrane in a rat model of ventral hernia repair with polypropylene mesh--a randomized, controlled study1 Surgery1. 1999. 125:211–61.
141.Wisniewski HG., Vilcek J. TSG-6: an IL-1/TNF-inducible protein with anti-inflammatory activity1 Cytokine Growth Factor Rev1. 1997. 8:143–561.
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