Improved Techniques of Applying Fibrin Glue in Lung Surgery

Abstract

To enhance the adhesive property of fibrin glue, two techniques were developed. The first is an improvement of the conventional layer method, and the second is a further improvement of the first technique. Their adhesive properties were tested in canine lungs in two phases. In phase 1 of the experiment, two new techniques were compared with the conventional methods in the retrieved lung. In phase 2 of the experiment, the second technique examined how its adhesive properties changed after treatment comparing them with gelatin-resorcinol-formaldehyde-glutaraldehyde (GRFG) glue. In phase 1, the first technique showed a 3-fold enhancement of the adhesive properties as compared with the conventional methods, and with the second technique the adhesive properties were further improved by more than 2-fold in the retrieved canine lung. In phase 2, it was revealed that the bursting pressure of both the second new technique and GRFG glue was eventually equal, and enough to close the cut surface of the lung. In the clinical setting, two techniques showed a safe and satisfactory performance in closing the cut surface of the lung. Due to the low toxicity of fibrin glue and absorbable material, these two techniques, especially the second technique, provide better circumstances for the healing of lung injury.

The optimal technique for combined application of fibrin sealant and bioabsorbable felt against alveolar air leakage☆☆☆

“…Thoracic surgeons, however, have often found that fibrin sealant used for pulmonary parenchymal defects could not effectively seal air leakages. To overcome this drawback, the application of fibrin sealant in combination with synthetic bioabsorbable sheet has been developed as a more effective tool for the control of alveolar air leakage [5][6][7]. Some studies have experimentally shown that this combination provides a better sealing effect than the fibrin sealant alone [6,7], and this combination is presently being used to a great extent in pulmonary surgery.…”

“…To overcome this drawback, the application of fibrin sealant in combination with synthetic bioabsorbable sheet has been developed as a more effective tool for the control of alveolar air leakage [5][6][7]. Some studies have experimentally shown that this combination provides a better sealing effect than the fibrin sealant alone [6,7], and this combination is presently being used to a great extent in pulmonary surgery. A variety of techniques for the combined application of these two materials have been reported along with their efficacy [7][8][9][10]; however, thus far, there are no comparative studies of these combined applications that reveal the technique with an optimum sealing effect.…”

“…Some studies have experimentally shown that this combination provides a better sealing effect than the fibrin sealant alone [6,7], and this combination is presently being used to a great extent in pulmonary surgery. A variety of techniques for the combined application of these two materials have been reported along with their efficacy [7][8][9][10]; however, thus far, there are no comparative studies of these combined applications that reveal the technique with an optimum sealing effect. Presently, we have developed a novel Rub + Soak B technique that involves rubbing the lung tissue with fibrinogen solution and sheet impregnation with thrombin solution, followed by attaching the sheet to the rubbed area.…”

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.…”

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

“…[1][2][3] A bioabsorbable polyglycolic acid (PGA) mesh sheet soaked in fibrin glue is one of the most prevalent sealants. However, the most unfavorable aspect of this sealant is that the fibrin glue is derived from blood products.…”