• 대한족부족관절학회지
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• 제21권4호
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• pp.151-155
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• 2017

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 $Guardix^{(R)}$ 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% nondelaying. In the non-using group, the delay was 63.3%, while non-delay was 36.7% (p<0.001). The group that underwent $Guardix^{(R)}$ 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 $Guardix^{(R)}$ injection, regarding the range of motion, visual analog scale, and healing of the wound postoperatively.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.543-547
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• 2009

Purpose: Adhesion is the most common and troublesome complication after repair of flexor tendon injury. Recently, use of sodium hyaluronate derivatives for adhesion prevention is increasing. A commercial product, Guardix$^{(R)}$, sodium hyaluronate(NaHe) combined with carboxymethylcellulose(CMC) has been newly developed as a preventive material for adhesion. We have investigated its effect in rabbits. Methods: Twenty seven male New Zealand white rabbits were operated under ketamine anesthesia. After tendon repair in zone II of the hind paw, Guardix$^{(R)}$(experimental group) or normal saline(control group) was administered. Biomechanical tests were performed to estimate adhesion formation at 2, 4, 8, and 12 weeks after the operation. Maximum tensile load to flex the distal interphalangeal joint 50 degree from its resting state(MTL50) was measured, depicting the amount of adhesion formed. Subsequently, breaking strength was assessed. Results: There were no postoperative complications such as infection, wound dehiscence, or hematoma. MTL50 was significantly lower in the experimental group than in the control group at 4, 8, 12 weeks (p<0.05). Mean value of MTL50 was 6.64N in the experimental group and 28.53N in the control group at 12 weeks after surgery. There were no significant differences in breaking strength. Conclusion: Our results indicate that Guardix$^{(R)}$ is helpful in reducing adhesion formation and does not interfere with normal healing processes of the tendon.

• Journal of Chest Surgery
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• 제43권6호
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• pp.596-601
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• 2010

배경: 심장막유착에 hyaluronic acid와 sodium carboxymethyl cellulose 혼합용액 (HA-CMC solution, $Guardix-sol^{(R)}$)의 유착방지 효과를 평가하기 위해 본 연구를 시행하였다. 대상 및 방법: 30마리의 흰쥐를 각각 15마리씩 2그룹으로 나누었으며 기계적 마찰을 통해 심장막 중피 손상을 유발시켰다. 대조군은 혈액과 생리식염수를, 실험군은 혈액과 HA-CMC 혼합용액을 심장막공간에 주입하였다. 수술후 2주, 4주, 6주에 5마리씩 심장막유착의 정도를 평가하였다. 유착의 정도를 육안으로 평가하였으며, 유착조직의 두께는 Masson trichrome염색과 영상처리프로그램을 통해 현미경적 분석을 시행하였다. 결과: 육안적검사상 실험군에서 유착점수가 대조군에 비해 유의하게 낮았다($2.9{\pm}0.6$ : $3.9{\pm}0.4$, p < 0.000). 실험군에서 유착조직두께는 대조군에 비해 낮았으나 통계적으로 유의하지는 않았다($91.73{\pm}49.91$ : $117.67{\pm}46.4$, p=0.106). 결론: 실험동물 모델에서 HA-CMC용액 ($Guardix-sol^{(R)}$)의 유착형성을 감소시키는 것을 관찰하였다.

• Journal of Korean Neurosurgical Society
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• 제59권3호
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• pp.250-258
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• 2016

Objective : A common cause of failure in laminectomy surgery is when epidural, peridural, or perineural adhesion occurs postoperatively. The purpose of this study is to examine the efficacy of a temperature-sensitive, anti-adhesive agent (TSAA agent), Guardix-SG$^{(R)}$, as a mechanical barrier for the prevention or reduction of peridural scar adhesion in a rabbit laminectomy model. Methods : Twenty-six mature rabbits were used for this study. Each rabbit underwent two separate laminectomies at lumbar vertebrae L3 and L6, left empty (the control group) and applied 2 mL of the TSAA agent (the experimental group), respectively. Invasive scar formation or inflammation after laminectomy was quantitatively evaluated by measuring the thickness of the dura, the distance from the surface of dura to the scar tissues, the number of inflammatory cells in the scar tissues at the laminectomy site, and the concentration of collagen in histological sections. Results : At 6 weeks postsurgery, the dura was significantly thinner and the distance from the surface of dura to the scar tissues was greater in the experimental group than in the control group (p=0.04 and p=0.01). The number of inflammatory cells was not significantly different in the two groups (p=0.08), although the mean number of inflammatory cells was relatively lower in the experimental group than in the control group. Conclusion : The current study suggests that the TSAA agent, Guardix-SG$^{(R)}$, could be useful as an interpositional physical barrier after laminectomy for the prevention or reduction of adhesion.

• 한국임상수의학회지
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• 제25권6호
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• pp.494-500
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• 2008

The aim of this study was to determine the effectiveness of hyaluronic acid-carboxymethylcellulose membrane (GUARDIX-$MB^{(R)}$) barriers on prevention against post-operative peritoneal adhesions. In this study, fourteen mongrel dogs were divided into two experimental groups: 0.1 % hyaluronic acid (0.1HA) group and hyaluronic acidcarboxymethylcellulose membrane (HA-CMC) group. In order to induce adhesions, the anti-mesenteric serosa of the ileum was exteriorized and then abraded in a standard manner by scraping with a scalpel blade to create homogenous petechial hemorrhagic surface over a $1\;{\times}\;1cm$ area. Solution of 0.1HA were simply coated over the abraded tissues, $1.5\;{\times}\;1.5cm$ HA-CMC membrane was placed over the abraded tissues, allowed to spread across the intra-abdominal organs before closure of the abdomen. On day 1 before and day 1, 4, 7, 14, and 21 after operation, venous blood specimens were collected for measurement of fibrinogen and total WBC. The adhesions were blindly assessed 3 weeks later by using a computerized tensiometer. The fibrinogen and total WBC values of two groups showed no statistical significances. The mean tensile strength (gram force, gf) of formed adhesions day 21 after surgery was $88.1\;{\pm}\;55.70gf$ in the 0.1 % HA group and $24.8\;{\pm}\;22.69gf$ in the HA-CMC group. The tensile strength values of adhesion separation HA-CMC membrane group was significantly lower than the 0.1HA group (p<0.05). Therefore, we suggest that HACMC membrane reduce peritoneal adhesions may be applicable to preventing post-operative intraperitoneal adhesions in dogs.

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2007년도 춘계학술대회
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• pp.134-134
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• 2007

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2006년도 추계학술대회 및 정기총회
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• pp.87-87
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• 2006