Efficacy and safety of temperature-sensitive acellular dermal matrix in prevention of postoperative adhesion after thyroidectomy: A randomized, multicenter, double-blind, non-inferiority study

INTRODUCTION: MegaShield(®) is a newly developed temperature-sensitive anti-adhesive containing micronized acellular dermal matrix. The aim of this study was to investigate the efficacy and safety of MegaShield(®) compared with Guardix-SG(®) in the prevention of adhesions in patients undergoing bilateral total thyroidectomy. METHOD: We conducted a multicenter trial between October 2018 and March 2020 in patients undergoing total thyroidectomy. The patients were randomly assigned to either the MegaShield(®) group or the Guardix-SG(®) group. The primary outcome was the esophageal movement using marshmallow six weeks after the surgery and the secondary outcome was the assessed adhesion score. The safety assessment was also evaluated. RESULTS: The study included 70 patients each in the MegaShield(®) and control (Guardix-SG(®)) groups. Baseline clinical characteristics, the mean score of marshmallow esophagography, and the sum of adhesion scores were not statistically different between the two groups. Inferiority test demonstrated that the efficacy of MegaShield(®) is not inferior to that of Guardix-SG®. There were no device-related complications in both groups. CONCLUSION: The efficacy and safety of MegaShield(®) were not inferior than those of Guardix-SG(®). MegaShield(®) demonstrated the potential of ADM as a potential future anti-adhesive agent. TRIAL REGISTRATION: The name of trial registry CRIS (Clinical Research Information Service) https://cris.nih.go.kr/cris/index.jsp. (The full trial protocol can be accessed) Registration number: KCT0003204.