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Development of an effective method utilizing fibrin glue to repair pleural defects in an ex-vivo pig model

BACKGROUND: The present study aimed to use an ex-vivo model to investigate whether a new method involving the use of fibrin glue and a polyglycolic acid (PGA) sheet under ventilation enhances the sealing effect after repair of the pleural defect. METHODS: Ex-vivo pig lungs were used in this study. W...

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Detalles Bibliográficos
Autores principales: Kondo, Nobuyuki, Takegawa, Yoshitaka, Hashimoto, Masaki, Matsumoto, Seiji, Oka, Shiro, Hasegawa, Seiki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7245928/
https://www.ncbi.nlm.nih.gov/pubmed/32448399
http://dx.doi.org/10.1186/s13019-020-01158-3
Descripción
Sumario:BACKGROUND: The present study aimed to use an ex-vivo model to investigate whether a new method involving the use of fibrin glue and a polyglycolic acid (PGA) sheet under ventilation enhances the sealing effect after repair of the pleural defect. METHODS: Ex-vivo pig lungs were used in this study. We investigated the maximum pressure tolerance of pleural defects repaired using three methods: 1, directly spraying fibrin glue over a PGA sheet; 2, spreading fibrinogen on the site then sealing with a PGA sheet and spraying with fibrin glue; and 3, spreading fibrinogen while maintaining ventilation then sealing with a PGA sheet and spraying with fibrin glue. RESULTS: The maximum tolerable pressures were as follows (mean ± standard deviation, cmH(2)O): Method 1, 37.1 ± 13.6, Method 2, 71.4 ± 27.7, Method 3, 111.5 ± 8.8. Histological findings explained the difference in tolerable pressure at the repaired site between methods. Microscopic findings of lungs repaired using Method 3 indicated that the fibrinogen penetrated into deeper tissues to act as an anchor. CONCLUSIONS: Fibrin glue sealing under ventilation increases the anchoring effect of repairing air leakages due to pleural defect in an ex-vivo model. This method may have clinical application. For example, it may be useful to reduce severe air leakage in patients who undergo lung-sparing surgery for a pleural tumor.