The Application Of PDLLA (Poly-DL-lactic Acid) Biological Absorbable Film In Thyroid Surgeries

Objective:To investigate and study the feasibility and effectiveness of PDLLA (Poly-DL-lactic acid) biological absorbable film in thyroid surgeries, to find if the film can reduce the adhesion and protect the recurrent laryngeal nerve and relieve the dragging sensation and contracture feeling in the neck after the thyroid surgery. To find a new way to protect recurrent laryngeal nerve, so that can promote and improve the recovery of the voice of the patient after thyroid surgery.Material and Methods:PDLLA (Poly-DL-lactic acid) biological absorbable films were purchased from Guangzhou Hongjian Biological Preparation Co. Ltd.And the films are high-tech molecular products which are mainly composed of poly-DL-lactic acid.120patients were randomly allocated into control and experimental groups, with60patients in each group. And according to different exposure of the recurrent laryngeal nerves, the above groups are divided into unilateral RLN group and bilateral RLN group.In the experimental group, PDLLA biological films were placed in the operative region and on the surface of the recurrent laryngeal nerve and also placed on in the superfacial layer of cervical fascia, which is between the platysma and sternohyoid muscles. The PDLLA films were not used in the control group.These patients were regularly follow-up after the surgery on the operational day, the third day after, the fifth day after, the first month after, and the sixth month after the operation. The main outcome measures were the voice and the dragging sensation and contracture feeling around the neck of the patients after the surgery between the two groups.Results:For the patients in the experimental and control groups, both in the unilateral and bilateral RLN groups, the dragging sensation and contracture feeling around the neck was significantly different in statistics after Chi-square tests(p<0.05) on the first month; there is no significant difference in statistics on the sixth month (p>0.05). For the entire experimental and the control groups, no hoarse patients appear on the operational day. After2or3days,1hoarse patient in the experimental group (1.67%,1/60) while3hoarse patients appears in the control group (5.0%,3/60), the odds ratio is3.0. The total delayed on-set hoarse patients are four(3.33%,4/120).For the patients in the unilateral and bilateral RLN group, there is no significant difference in statistics for the experimental and control gourp.For the experimental and the control groups in both unilateral and bilateral RLN groups,theres is sign:(?) statistical difference in e(?)onic laryngoscope outcomes on the sixth month (p<0.05) while there is no significant statistical difference on the fifth day (p>0.05).Conclusion:The PDLLA medical biological absorbable films can protect the recurrent laryngeal nerves and promote and improve the recovery of the voices of the patients who received thyroid surgery.The PDLLA medical biological absorbable films can reduce and relieve the painful feeling of the dragging sensation and contracture feeling around the neck in the patients who received thyroid surgery, and improve their postoperative quality of life.