Local and systemic effects of fibrin and cyanoacrylate adhesives on lung lesions in rabbits

Abstract

OBJECTIVES:Tissue adhesives can be used to prevent pulmonary air leaks, which frequently occur after lung interventions. The objective of this study is to evaluate local and systemic effects of fibrin and cyanoacrylate tissue adhesives on lung lesions in rabbits.METHODS:Eighteen rabbits were submitted to videothoracoscopy + lung incision alone (control) or videothoracoscopy + lung incision + local application of fibrin or cyanoacrylate adhesive. Blood samples were collected and assessed for leukocyte, neutrophil and lymphocyte counts and interleukin-8 levels preoperatively and at 48 hours and 28 days post-operatively. After 28 days, the animals were euthanized for gross examination of the lung surface, and lung fragments were excised for histopathological analysis.RESULTS:Fibrin and cyanoacrylate produced similar adhesion scores of the lung to the parietal pleura. Microscopic analysis revealed uniform low-cellular tissue infiltration in the fibrin group and an intense tissue reaction characterized by dense inflammatory infiltration of granulocytes, giant cells and necrosis in the cyanoacrylate group. No changes were detected in the leukocyte, neutrophil or lymphocyte count at any time-point, while the interleukin-8 levels were increased in the fibrin and cyanoacrylate groups after 48 hours compared with the pre-operative control levels (p<0.01).CONCLUSION:Both adhesive agents promoted normal tissue healing, with a more pronounced local inflammatory reaction observed for cyanoacrylate. Among the serum markers of inflammation, only the interleukin-8 levels changed post-operatively, increasing after 48 hours and decreasing after 28 days to levels similar to those of the control group in both the fibrin and cyanoacrylate groups.

Bio-macromolecular design roadmap towards tough bioadhesives

“…Recent Food and Drug Administration (FDA)-approved commercial sealants based on fibrin (Tisseel s , Evicel s , Vitagelt, etc.) 20 are used for lung incisions, 21 hernia repair, 22 treatment of refractory chylous ascites, 23 skin grafts in burn surgery, 24 and cleft palate repair. 24 Most commercial sealants lack sufficient adhesion strength and durability, and they are prone to inducing immune responses in vivo.…”