Use of oxidized and regenerated cellulose in thyroid surgery: a prospective analysis as cause of postoperative hypocalcemia on 485 patients consecutively treated.
OBJECTIVE
The intraoperative hemorrage determines an higher risk of parathyroid glands lesions, and laryngeal nerve injuries. We have examined if the use of oxidized and regenerated cellulose could be a cause of postoperative hypocalcemia because of the compression on the parathyroid glands or for tissue adhesions


METHODS
From June 2009 to December 2010 we have examined 485 patients consecutively treated with total thyroidectomy. The cases examined were divided in two groups on the use of ionized cellulose (group A and B). 24 hours after surgical procedure, all patients were submitted to serum calcium evaluation. The data were analyzed with χ2 test and t-student test; P<0.05 was statistically significant.


RESULTS
We have selected 372 cases out of 485 examined. We have registered after 10 hours from surgical procedure a case of hemorrhage with reintervention in group B (no use of cellulose). The cost of ionized cellulose is € 46; we have used this device in 212 cases on 372 patients undergone to total thyroidectomy, with a cost of € 9 752. The mean value of the serum calcium was statistically different between pre- and postoperative evaluation in all cases (P<0.0001) divided both on gender and on the use of hemostatic devices.


CONCLUSIONS
In our experience, there isn't a statistically significant difference on incidence of postoperative hypocalcemia, related to use of ionized and regenerated cellulose on mean surgical time in all patients either treated with traditional surgery or with video-assisted procedure.
University Hospital of Parma, Parma, Italy. paolo.delrio@unipr.it
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P
Del Rio
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Cataldo
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Pisani
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De Simone
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Iapichino
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Sianesi
D000328:Adult; D000368:Aged; D000465:Algorithms; D015415:Biomarkers / Q000097:blood; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D002118:Calcium / Q000097:blood*; D002483:Cellulose, Oxidized / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D006996:Hypocalcemia / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects
D015415:Biomarkers; D002483:Cellulose, Oxidized; D006490:Hemostatics; D002118:Calcium