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Kim and Kwon: Clinical Application and Effects of Sodium Hyaluronate-Carboxymethylcellulose (Guardix®) in Surgery of Ankle Fractures
Original Article

J Korean Foot Ankle Soc 2017;21(4):151-155.

Published online: 19 January 2017

DOI: https://doi.org/10.14193/jkfas.2017.21.4.151

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

Gab Lae Kim, Hwan Jin Kwon

Department of Orthopaedic Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea

Corresponding Author: Gab Lae Kim Department of Orthopaedic Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 150 Seongan-ro, Gangdong-gu, Seoul 05355, Korea Tel: 82-2-2224-2230, Fax: 82-2-488-0114, E-mail: kiga9@hallym.or.kr

Received 17 October 201730 October 2017       Accepted 30 October 2017

Copyright © 2017 Korean Foot and Ankle Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Adhesion, Guardix®, Sodium hyaluronate-carboxymethylcellulose, Ankle joint fracture, Range of motion

REFERENCES

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Table 1.
Difference of Tenderness on Scar whether Guardix® Was Used or Not
Tenderness on scar Guaardix® χ 2
Used (n=30) Not (n=30)
2 wk Yes 1 (3.3) 16 (53.3) 18.468***
No 29 (96.7) 14 (46.7)
6 wk Yes 7 (23.3) 7 (23.3) 0.000
No 23 (76.7) 23 (76.7)
12 wk Yes 5 (16.7) 1 (3.3) 2.963
No 25 (83.3) 29 (96.7)

Values are presented as number (%). ***p<0.001.

Table 2.
Difference of Delay of Scar Healing whether Guardix® Was Used or Not
Delay of scar Guaardix® χ 2
Used (n=30) Not (n=30)
Yes 2 (6.7) 19 (63.3) 21.172***
No 28 (93.3) 11 (36.7)

Values are presented as number (%). ***p<0.001.

Table 3.
Difference of 100-mm VAS whether Guardix® Was Used or Not
100-mm VAS N Mean rank Rank sum Mann-Whitney U-test p-value
Used 30 18.03 541.00 76.000 0.000
Not 30 42.97 1,289.00

VAS: visual analogue scale.

Table 4.
Difference of ROM (Dorsiflexion, Plantarflexion) whether Guardix® Was Used or Not
ROM N Mean rank Rank sum Mann-Whitney U-test p-value
Dorsiflexion (2 wk) Used 30 31.50 945.00 420.000 0.154
Not 30 29.50 885.00
Plantarflexion (2 wk) Used Not 30 30 31.50 29.50 945.00 885.00 420.000 0.154
Dorsiflexion (6 wk) Used 30 39.82 1,194.50 170.500*** 0.000
Not 30 21.18 635.50
Plantarflexion (6 wk) Used 30 38.57 1,157.00 208.000*** 0.000
Not 30 22.43 673.00
Dorsiflexion (12 wk) Used Not 30 30 35.85 25.15 1,075.50 754.50 289.500** 0.002
Plantarflexion (12 wk) Used 30 35.85 1,075.50 289.500** 0.002
Not 30 25.15 754.50

ROM: range of motion. **p<0.01, ***p<0.001.

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