• Journal of Korean Foot and Ankle Society
• /
• v.21 no.4
• /
• pp.151-155
• /
• 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
• /
• v.36 no.5
• /
• pp.543-547
• /
• 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.

• Membrane Journal
• /
• v.15 no.3
• /
• pp.213-223
• /
• 2005

We prepared an anti-adhesion membrane made of sodium hyaluronate/sodium carboxymethylcellulose (HA/CMC) and evaluated its effectiveness for adhesion prevention in a rat model. The anti-adhesion membrane was prepared by lyophilizing HA/CMC solution and cross-linking properly with 1-Ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDAC). In a cecum/abdominal wall abrasion model of Sprague-Dawley rat, cecal serosa and abdominal wall were abraded in $1\times2\;(cm^2)$ with a bone burr after peritoneal midline incision and sutured at 3 points around the injured surface. The denuded cecum was covered with HA/CMC membrane (experimental group), or nothing (control group) and apposed to the abdominal wall. Most of the control group represented 3 or more of adhesion grade at POD 7, 14, 21, and 28, whereas $60\~70\%$ of the experimental group was 2 or less of adhesion grade at 14, 21, and 28. It was similar in the adhesion strength. In a general manner, the adhesion grade and strength showed gradual increasing until POD 14, almost same or a little increasing POD 21, but decreasing POD 28. Also the control group was much higher in adhesion grade, strength, and area than the experimental group. It is expected that the anti-adhesion membrane will have a good clinical result in postoperative adhesion prevention.