A New Cross-Linked Hyaluronic Acid Gel for Preventing Adhesion After Thyroid Surgery: An Animal Study

Aksakal N., Goksoy B., Onder S. Y., Dogan S., GÖK A. F. K., Barbaros U.

JOURNAL OF SURGICAL RESEARCH, vol.265, pp.147-152, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 265
  • Publication Date: 2021
  • Doi Number: 10.1016/j.jss.2021.03.044
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Page Numbers: pp.147-152
  • Keywords: Thyroidectomy, Hyaluronic acid gel, Redo neck surgery, Neck dissection, POSTOPERATIVE ADHESIONS, SODIUM HYALURONATE, SAFETY, CELLULOSE, PATHOGENESIS, COMPLETION, EFFICACY, RAT
  • Istanbul University Affiliated: Yes


Background: Revision of any neck surgeries is usually associated with increased rate of complications compared to the initial surgery due to adhesions. Especially, recurrent laryngeal nerve injury and hypoparathyroidism are most important postoperative complications of thyroid revision surgery. This study aimed to reveal anti-adhesive effects of cross-linked hyaluronic acid gel (NCHAG) in thyroid surgery. Materials and methods: This study was performed in 16 adult male rats who underwent hemithyroidectomy in the right lobe and randomized into two experimental groups: Group I (control group) was given any substance and Group II (NCHA group) received NCHA spray into their perithyroidal area. The rats were sacrificed after three weeks of thyroidectomy for assessment. Results: Gross adhesions score (x & macr; = 2.500) was significantly higher in Group I than Group II (x & macr;= 1.750; P = 0.031). Group II showed significantly less fibrosis compared to the Group I ( P = 0.002). The rate of inflammation was found to be significantly higher in group I ( P = 0.008). Vascular proliferation was not different between two groups (p = 0.083). Conclusions: Our study showed that NCHA can reduce postoperative adhesion and might be effective in preventing fibrosis after the thyroidectomy. Although this study could not demonstrate that application of NCHA is able to reduce complication rate in revision neck surgery, it could be safely used after thyroidectomy and neck surgeries to prevent adhesions. (c) 2021 Elsevier Inc. All rights reserved.