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

Abstract

Polyglycolic acid felt can be used safely in general thoracic surgery and did not influence the incidence or type of SSI. Surgeons should be aware of the possibility of adhesion around the material at the time of re-operation, and the criteria of PGA use should be strictly discussed.

Microscopic Findings of Sheet-Type Collagen Applied to Air Leaks after Pulmonary Resection

“…Nakamura et al reported the microscopic findings of PGA sheets that had been applied to the lungs 4 weeks earlier. 5) According to their report, there was robust adhesion between the parietal and visceral pleurae that required a pleurectomy for lobectomy. 5) However, in reoperation where Integran ® had been applied earlier, we found that the adhesion generated by Integran ® was gentle in comparison to that of a PGA mesh sheet soaked in fibrin glue.…”

“…5) According to their report, there was robust adhesion between the parietal and visceral pleurae that required a pleurectomy for lobectomy. 5) However, in reoperation where Integran ® had been applied earlier, we found that the adhesion generated by Integran ® was gentle in comparison to that of a PGA mesh sheet soaked in fibrin glue. Okubo et al reported that cotton-type collagen insertion at mediastinoscopy for lung cancer separated the mediastinal nodes from the trachea and made the node dissection easier.…”

“…Furthermore, severe adhesion makes reoperation difficult. 5) One of the useful aspects of Integran ® is that it contains no blood products. Another useful feature is that the ability of Integran ® to generate inflammation or adhesion is weak.…”

Prevention of Polyglycolic Acid-Induced Peritoneal Adhesions Using Alginate in a Rat Model

“…Intra-abdominal or intrathoracic adhesions develop after gastroenterological [ 1 , 2 ], thoracic [ 3 – 6 ], and gynecological [ 7 – 9 ] surgeries. Adhesions sometimes cause bowel obstructions, chronic abdominal pain or discomfort, female infertility [ 2 – 4 , 7 , 8 , 10 , 11 ], and difficulties with subsequent surgeries, as well as prolonged hospitalization and hospital readmissions, which could have an impact on both the patient's well-being and healthcare costs [ 11 , 12 ].…”

“…A mesh of polyglycolic acid (PGA) is a widely used biomaterial during gastroenterological [ 13 ], thoracic [ 6 , 14 – 16 ], and gynecological surgeries [ 9 ] and is used, for example, as reinforcement for weak tissues. The mild acidity of glycolic acid, produced during the nonenzymatic degradation of PGA [ 17 ], causes chronic inflammation, and adhesions subsequently occur around the site where the PGA mesh was placed [ 3 , 18 ].…”