족관절 골절 수술에서의 유착방지제(Guardix®)의 효과 연구
Clinical Application and Effects of Sodium Hyaluronate-Carboxymethylcellulose (Guardix®) in Surgery of Ankle Fractures
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Purpose: Reducing tenderness or pain on the ankle joint and improving the range of motion are thought to be possible using hyaluro『nate-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 in『cluded 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 signifi『cant 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 ana『log scale, and healing of the wound postoperatively.
Abstract
Purpose: Reducing tenderness or pain on the ankle joint and improving the range of motion are thought to be possible using hyaluro『nate-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 in『cluded 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 signifi『cant 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 ana『log scale, and healing of the wound postoperatively.
참고문헌 (14)
- Cimino W, "Early mobilization of ankle fractures after open reduction and internal fixation", Clin Orthop Relat Res, (267), pp.152~156 (1991)
- Finsen V, "Early postoperative weight-bearing and muscle activity in patients who have a fracture of the ankle", J Bone Joint Surg Am, 71, pp.23~27 (1989)
- Burwell HN, "The treatment of displaced fractures at the ankle by rigid internal fixation and early joint movement", J Bone Joint Surg Br, 47, pp.634~660 (1965)
- 송형준, "복벽 손상 백서에서 세가지 유형의 유착방지제의 효과", 대한외과학회지, 77(1), pp.7~14 (2009), 대한외과학회
- Dijkstra FR, "Recent clinical developments in pathophysiology, epidemiology, diagnosis and treatment of intra-abdominal adhesions", Scand J Gastroenterol Suppl, (232), pp.52~59 (2000)
- Rout UK, "Role of plasminogen activators during healing after uterine serosal lesioning in the rat", Fertil Steril, 79, pp.138~145 (2003)
- Holmdahl L, "The role of cytokines, coagulation, and fibrinolysis in peritoneal tissue repair", Eur J Surg, 165, pp.1012~1019 (1999)
- Herrick SE, "Human peritoneal adhesions are highly cellular, innervated, and vascularized", J Pathol, 192, pp.67~72 (2000)
- Kim JH, "Antiadhesive effect of the mixed solution of sodium hyaluronate and sodium carboxymethylcellulose after endoscopic sinus surgery", Am J Rhinol, 21, pp.95~99 (2007)
- Ellis H, "Adhesion-related hospital readmissions after abdominal and pelvic surgery : a retrospective cohort study", Lancet, 353, pp.1476~1480 (1999)
- Lower 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 Study", BJOG, 107, pp.855~862 (2000)
- 심희수, "백서에서 수술 후 복부 유착방지용 재료들의 효능평가", 대한외과학회지, 63(3), pp.179~186 (2002), 대한외과학회
- Hooker GD, "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 study", Surgery, 125, pp.211~216 (1999)
- Wisniewski HG, "TSG-6 : an IL-1", TNF-inducible protein with anti-inflammatory activity, 1997, pp.8, 143~156