Comparison of four commercially available adhesion barriers after open thyroid surgery: a prospective observational study.

PURPOSE: Postoperative cervical adhesions after thyroidectomy can lead to neck tightness, dysphagia, and cosmetic dissatisfaction, but the clinical benefits of antiadhesion agents remain unclear. This study compared the efficacy and safety of four commercially available antiadhesion agents applied after open thyroid surgery. METHODS: This singlecenter prospective observational study at a tertiary care hospital included included patients aged 20-70 years undergoing their first open thyroid surgery with intraoperative application of 1 of 4 agents: MegaShield (MS; L&C Bio Co., Ltd.), MegaDerm (MD; L&C Bio Co., Ltd.), CollaBarrier (CB; Dalim Tissen Co., Ltd.), or ACE COL (AC; Korea BNC Co., Ltd. and IreBio Co., Ltd.). Two units were applied at the tracheal bed and subcutaneous layer at the end of surgery. A 7item adhesion questionnaire and the Vancouver Scar Scale (VSS) were assessed at 2 and 12 weeks postoperatively by an independent evaluator. Adverse events were recorded at each visit. Group differences were analyzed using nonparametric tests. RESULTS: Of 200 enrolled patients, 180 completed followup (MS, 46; MD, 45; CB, 47; and AC, 42). Baseline characteristics were comparable. Adhesion scores increased at 2 weeks and improved by 12 weeks in all groups, with no significant betweengroup differences at any time point. VSS total scores showed a similar pattern, with only a transiently higher pigmentation score at 2 weeks in the MS group; no differences persisted at 12 weeks. Complication rates were low and similar across groups. CONCLUSION: Four different antiadhesion agents demonstrated comparable shortterm efficacy for adhesionrelated symptoms and scar quality after open thyroid surgery, with no clinically meaningful superiority of any single agent. All products were well tolerated.