The short-term efficacy of fibrin glue combined with absorptive sheet material in visceral pleural defect repair

Abstract

Tissue sealants can prevent the occurrence of pulmonary air leakage, although few studies have evaluated the seal-breaking pressure properties of the various methods. We developed a new method for repairing visceral pleural defects which combines fibrin glue with a sheet material. We used an animal model to compare its efficacy with that of three current techniques up to 24 h after application. Under thoracotomy, 5 x 20 mm visceral pleural defects with a depth of 3 mm were made in beagles. The defects in the normal lungs were repaired using 1 of 4 methods: Method A, fibrin-glue double layer (fibrinogen solution was dripped, followed by thrombin solution); Method B, pack method (fibrin glue combined with polyglycolic acid sheet); Method C, rubbing and spray (fibrinogen was rubbed, followed by spraying of both fibrinogen and thrombin solutions); Method D, fibrin-glue-coated collagen fleece. The defects were repaired also in an emphysematous lung model using Method A, B or C. In the normal lungs, Method B showed significantly higher pressure resistance compared with the other methods at 5 min, 1 and 3 h post-application. Pressure resistance increased with time for all methods. In the emphysematous lungs, Method B showed significantly higher seal-breaking pressure than Methods A and C. Compared with existing tissue sealant methods, the pack method reliably controlled pulmonary air leakage immediately after application.

Pleural defect repair with an overlapping method using fibrin glue-coated collagen fleece

“…Furthermore, it is sometimes diffi cult to suture or plicate a large defect or a lung weakened by emphysema, thereby leaving overlapping as the most appropriate and simple method to repair the defect. 3 Fibrin glue-coated collagen fl eece (TachoComb; CSL Behring, Tokyo, Japan), is a stretchable and adhesive tissue sealant that can be used to repair pleural defects and hemorrhage. Pressure is constantly applied to a pleural defect by ventilation; the collapse and infl ation of the lung changes the shape and size of the defect.…”

Mesh-Based Pneumostasis Contributes to Preserving Gas Exchange Capacity and Promoting Rehabilitation After Lung Resection

“…Subsequently, they found that the use of PGA mesh in combination with fibrin glue, with the use of rubbing method, could achieve the highest sealing potential in an animal model [16,17]. Currently, PGA mesh and fibrin glue are commonly used not only in respiratory surgery but also in neurosurgery [18] and general surgery [19] in Japan.…”

An evaluation of the surgical morbidity of polyglycolic acid felt in pulmonary resections

“…The application of fi brin glue is one of the most frequent modalities and it is widely used, 2-6 whereas industrial materials have also been developed and are often combined with fi brin glue. [7][8][9][10][11] Polyglycolic acid felt is used for its effectiveness and safety. 11,12 A recent report noted its utility for hemostasis in a lacerated liver, and the application of PGA may expand in the future.…”

“…[7][8][9][10][11] Polyglycolic acid felt is used for its effectiveness and safety. 11,12 A recent report noted its utility for hemostasis in a lacerated liver, and the application of PGA may expand in the future. 13 Although PGA felt may cause postoperative infection, or empyema as organ/space SSI, there was no signifi cant difference in the incidence and type of SSI between the PGA(+) and PGA(−) group in the current study (Table 1).…”