Basic experiments of bioabsorbable materials in prevention of postoperative intrapleural adhesions following thoracotomy

Abstract

Reoperative pulmonary resection may be associated with a higher rate of postoperative complications secondary to postoperative adhesions. This review was designed to investigate the effect of a bioabsorbable material on postoperative intrapleural adhesions following thoracotomy. A search was performed in PubMed (United States National Library of Medicine) for original studies published in English and investigating a bioabsorbable material in preventing postoperative intrapleural adhesions, using the terms "pleural", "adhesion", and "surgery". Eight animal experimental studies (five rodents and three canines) were eligible for review. No human studies were identified. The type of bioabsorbable material was a sheet in five studies and a powder or spray in three studies. In five studies (62.5 %), a biomaterial included polymers. Six studies (75 %) suggested that a bioabsorbable material was effective in preventing intrapleural adhesions on the basis of statistical analysis. We conclude that a bioabsorbable material may prevent postoperative adhesions following thoracotomy and that available materials may reasonably be applied in clinical practice. Clinical trials on postoperative anti-adhesions are warranted in select patients.

Investigation of the effects of different drugs on the prevention of intrapleural adhesion in a rat model

“…Prevention of pleural adhesions studies, including our own study, were performed between the thoracic wall and the visceral pleura. [4,7,12] Different barrier studies, such as hyaluronate-based absorbable (HA) membrane, Interceed ® , Seprafilm ® and Prevadh ® have been reported to effectively reduce both abdominal and intrathoracic postoperative adhesion. [12,[17][18][19][20] Studies in rats with olive oil, garlic oil, argan oil, and honey which are among the organic substances mentioned in rumors from history, have also shown that postoperative intra-abdominal adhesion is reduced with these substances.…”

“…[ 5 ] Although experimental studies on the use of anti-adhesive biomaterials for thoracotomies have shown promising results, there are still many aspects that require further planning and investigation. [ 6 , 7 ]…”

“…[5] Although experimental studies on the use of anti-adhesive biomaterials for thoracotomies have shown promising results, there are still many aspects that require further planning and investigation. [6,7] In the present study, we aimed to investigate the concept of reducing possible intrapleural adhesions in patients undergoing rethoracotomy by systemically administering an easily available drug preoperatively instead of the previously-employed methods of using absorbable barriers.…”

The importance of antiadhesion treatment for the successful video-assisted thoracic surgery

“…Other membranous and powdered formulations of pleural adhesion-prevention agents have been reported (20). Many studies have examined pleural adhesions following conventional thoracotomy; however, we examined the potential use of adhesion-preventive agents during VATS, based on agent operability (18).…”

Intrathoracic retention of insoluble hyaluronic acid and its absorption process in rats

“…Post-thoracotomy adhesions occur frequently and are known to be postoperative complications that add significant risk to subsequent thoracotomy procedures. 1,2 Although there is substantial history in the development of postoperative thoracic adhesion barriers, 3 there are currently no products on the market, and development is still ongoing. Our previous study was reported that the use of an insoluble hyaluronic acid membrane was very highly effective in preventing post-thoracotomy pleural adhesions in dogs.…”