In vivo comparative assessments on pleural adhesive effects of three commercially available sealantsCentral MessagePerspective

Objective: Surgical sealant, which is used for the reinforcement of suture lines, has been widely used in lung-resection surgeries with the aim of reducing postoperative morbidity; however, it may exacerbate surgical-site adhesion, creating the risks of restrictive thoracic movement and a difficult...

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Main Authors: Jonggeun Lee, MD, Ahrong Kim, MD, PhD, Hyo Yeong Ahn, MD, PhD, Joon Bum Kim, MD, PhD
Format: Article
Language:English
Published: Elsevier 2024-08-01
Series:JTCVS Techniques
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666250724001640
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author Jonggeun Lee, MD
Ahrong Kim, MD, PhD
Hyo Yeong Ahn, MD, PhD
Joon Bum Kim, MD, PhD
author_facet Jonggeun Lee, MD
Ahrong Kim, MD, PhD
Hyo Yeong Ahn, MD, PhD
Joon Bum Kim, MD, PhD
author_sort Jonggeun Lee, MD
collection DOAJ
description Objective: Surgical sealant, which is used for the reinforcement of suture lines, has been widely used in lung-resection surgeries with the aim of reducing postoperative morbidity; however, it may exacerbate surgical-site adhesion, creating the risks of restrictive thoracic movement and a difficult entrance for redo operation. We aimed to assess the pleural adhesive effects of 3 frequently used surgical sealants, (1) fibrin glue (fibrin), (2) a composite of polyethylene glycol and human serum albumin (PEG/HSA), and (3) bioabsorbable polyglycolic acid felt (PGA), in an in vivo setting. Methods: Eighty-one rats were randomly assigned to 3 experimental groups—fibrin, PEG/HSA, and PGA. After intrapleural application of the sealants, the extent and severity of adhesion and inflammation were quantitatively compared among the 3 groups at 2, 4, and 8 weeks. Results: The scores for both the extent and severity of adhesion were significantly greater in the PGA group than the other 2 groups throughout postoperative period (P < .001 for all). Although both scores in the PES/HSA and fibrin groups were 0 at 2 weeks, the fibrin group showed significantly greater scores than the PES/HSA group thereafter (P < .001 for all). Trends in inflammation scores were similar of those of adhesion scores, favoring the PES/HSA group followed by the fibrin group (P < .001 for all). Conclusions: Among 3 commonly used sealants, PEA/HSA showed least degree of adhesion/inflammation compared with fibrin and PGA, whereas PGA demonstrated greatest degrees of adhesion/inflammation throughout a postoperative course of 8 weeks in an in vivo model.
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spelling doaj-art-eab1836ed9304b97bfa91d4ca8eda5922025-08-20T03:38:24ZengElsevierJTCVS Techniques2666-25072024-08-012613113810.1016/j.xjtc.2024.04.007In vivo comparative assessments on pleural adhesive effects of three commercially available sealantsCentral MessagePerspectiveJonggeun Lee, MD0Ahrong Kim, MD, PhD1Hyo Yeong Ahn, MD, PhD2Joon Bum Kim, MD, PhD3School of Medicine, Pusan National University, Busan, Republic of Korea; Department of Thoracic and Cardiovascular Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of KoreaSchool of Medicine, Pusan National University, Busan, Republic of Korea; Department of Pathology, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of KoreaSchool of Medicine, Pusan National University, Busan, Republic of Korea; Department of Thoracic and Cardiovascular Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea; Address for reprints: Hyo Yeong Ahn, MD, PhD, Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, 305, Gudeok-Ro, Seo-Gu, Busan 602-739, Republic of Korea.Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaObjective: Surgical sealant, which is used for the reinforcement of suture lines, has been widely used in lung-resection surgeries with the aim of reducing postoperative morbidity; however, it may exacerbate surgical-site adhesion, creating the risks of restrictive thoracic movement and a difficult entrance for redo operation. We aimed to assess the pleural adhesive effects of 3 frequently used surgical sealants, (1) fibrin glue (fibrin), (2) a composite of polyethylene glycol and human serum albumin (PEG/HSA), and (3) bioabsorbable polyglycolic acid felt (PGA), in an in vivo setting. Methods: Eighty-one rats were randomly assigned to 3 experimental groups—fibrin, PEG/HSA, and PGA. After intrapleural application of the sealants, the extent and severity of adhesion and inflammation were quantitatively compared among the 3 groups at 2, 4, and 8 weeks. Results: The scores for both the extent and severity of adhesion were significantly greater in the PGA group than the other 2 groups throughout postoperative period (P < .001 for all). Although both scores in the PES/HSA and fibrin groups were 0 at 2 weeks, the fibrin group showed significantly greater scores than the PES/HSA group thereafter (P < .001 for all). Trends in inflammation scores were similar of those of adhesion scores, favoring the PES/HSA group followed by the fibrin group (P < .001 for all). Conclusions: Among 3 commonly used sealants, PEA/HSA showed least degree of adhesion/inflammation compared with fibrin and PGA, whereas PGA demonstrated greatest degrees of adhesion/inflammation throughout a postoperative course of 8 weeks in an in vivo model.http://www.sciencedirect.com/science/article/pii/S2666250724001640sealantspostoperative adhesionlung resection
spellingShingle Jonggeun Lee, MD
Ahrong Kim, MD, PhD
Hyo Yeong Ahn, MD, PhD
Joon Bum Kim, MD, PhD
In vivo comparative assessments on pleural adhesive effects of three commercially available sealantsCentral MessagePerspective
JTCVS Techniques
sealants
postoperative adhesion
lung resection
title In vivo comparative assessments on pleural adhesive effects of three commercially available sealantsCentral MessagePerspective
title_full In vivo comparative assessments on pleural adhesive effects of three commercially available sealantsCentral MessagePerspective
title_fullStr In vivo comparative assessments on pleural adhesive effects of three commercially available sealantsCentral MessagePerspective
title_full_unstemmed In vivo comparative assessments on pleural adhesive effects of three commercially available sealantsCentral MessagePerspective
title_short In vivo comparative assessments on pleural adhesive effects of three commercially available sealantsCentral MessagePerspective
title_sort in vivo comparative assessments on pleural adhesive effects of three commercially available sealantscentral messageperspective
topic sealants
postoperative adhesion
lung resection
url http://www.sciencedirect.com/science/article/pii/S2666250724001640
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