The role of BioGlue in thoracic surgery: a systematic review

Abstract

Background: BioGlue is a commonly used sealant in thoracic surgery. Prolonged air leak and presence of bronchopleural fistulae (BPF) are often encountered in clinical practice. We therefore, investigated the role and the efficacy of BioGlue in these scenarios.Methods: A systematic review was conducted by searching Medline and Cochrane CentralRegister of Controlled Trials (CENTRAL) [1999][2000][2001][2002][2003][2004][2005][2006][2007][2008][2009][2010][2011][2012][2013][2014][2015][2016] along with reference lists of the included studies.Included studies reported on thoracic surgery operations and use of BioGlue in thoracic surgical procedures, whereas excluded studies met at least one of the following criteria: non-English language studies, nonhuman population, studies on surgical specialties other than Thoracic surgery, reviews and meta-analyses and sealants other than BioGlue.Results: Twelve studies with a total number of 194 patients were included. Amongst them, 178 were treated for alveolar air leaks (AAL), 14 for BPF and 2 for lymphatic leaks. BioGlue was utilized at the time of initial operation in 172 (96.7%) patients for AAL, while at secondary intervention in 13 (92.9%) for BPF and 1 (50%) for lymphatic leak. In terms of AAL, only 2 out of 4 studies showed statistically significant reduction in duration of air leak, duration of intercostal drainage and length of stay (LOS) when BioGlue was applied.No complications were encountered after using BioGlue in sealing BPF, apart from the re-application of BioGlue in 3 cases.Conclusions: Although BioGlue has been shown to be efficient in treating AAL, it should be used with caution against BPF, despite encouraging preliminary results. Potential adverse effects must always be taken into consideration. Future randomized controlled trials are warranted in an attempt to establish its benefit in current clinical practice.

Management der postoperativ prolongierten Parenchymfistel

“…In diesen Fällen kann eine zeitnahe chirurgische Revision mit Aufsuchen der Fistellokalisation hilfreich sein. Zum Parenchymverschluss stehen verschiedene Möglichkeiten zur Auswahl: Fistelverschluss/-resektion mittels Hand-oder Klammernaht, Applikation von Gewebekleber [38] oder Fibrin-beschichtetem Kollagenflies, gegebenenfalls in Kombination mit einer Deckung mit autologem Gewebe. Letzteres spielt jedoch insbesondere bei der Therapie der Bronchusstumpfinsuffizienz eine Rolle.…”

Feasibility of the annulus fibrosus repair with in situ gelating hydrogels – A biomechanical study

“…Specifically regarding AF repair, early results using genipin crosslinked fibrin hydrogel (FibGen) have been promising in partially restoring biomechanics of the functional spine unit (FSU), however failing under higher ranges of physiological loads [16–19] [19]. Bioglue is a commercially available (FDA approved) hydrogel composed of glutaraldehyde and albumin [20,21]. It provides fast gelation time and good biocompatibility as the glutaraldehyde is mixed completely with the albumin within the application tube [22].…”

Structural factors of benzylated glucopyranans for shear-induced adhesion

“…The glass transition temperatures (T g ) were À5.6 C for Glcp-(1-2)-100, 13.7 C for Glcp-(1-2)-97, 19.3 C for Glcp-(1-2)-80, and 29.8 C for Glcp-(1-2)-80. 14 These results suggest that the benzyl protection makes the polymer chain plasticized and benzylated Glcp-(1-2) is more exible than benzylated Glcp- (1)(2)(3)(4).…”

“…The development of new bioglues has been strongly urged from the viewpoint of advancing biomedical engineering. [1][2][3][4] The shear-induced adhesion behaviors of von Willebrand factor (VWF) 5-7 is a nice motif to create a new bioglue. VWF is a mosaic plasma protein.…”

“…Gelatinized starch has been long used as an adhesive material for paper products and food additives. [8][9][10][11] Amylose as a Glcp bearing 1,4-glycosidic bonds [Glcp- (1)(2)(3)(4)] is the ingredient of starch (Fig. 1a).…”