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Open Access 01-12-2016 | Research article

Albumin-glutaraldehyde glue for repair of superficial lung defect: an in vitro experiment

Authors: Maximilian Bures, Hans-Klaus Höffler, Godehard Friedel, Thomas Kyriss, Enole Boedeker, Florian Länger, Patrick Zardo, Ruoyu Zhang

Published in: Journal of Cardiothoracic Surgery | Issue 1/2016

Abstract

Background

Albumin-glutaraldehyde glue gained a widespread acceptance in repair of superficial lung defects associated with alveolar air leaks (AAL). As its sealing efficacy has not yet been thoroughly corroborated by clinical studies, we sought to assess the properties of commercially available albumin-glutaraldehyde glue (BioGlue™) in an in vitro lung model.

Methods

The lower lobe of freshly excised swine lung (n = 10) was intubated and ventilated. A focal superficial parenchymal defect (40 × 25 mm) was created on the inflated lung. AAL was assessed with increasing inspired tidal volume (TVi). After glue application, AAL was assessed until burst failure occurred. To evaluate glue elasticity, the length of defect was recorded in the inflated lung.

Results

Superficial parenchymal defects resulted in AAL increasing with ascending TVi. Multiple linear regression analysis revealed strong correlation between AAL and maximal inspiratory pressure. There was one application error. At TVi = 400, 500, 600, 700, 800 and 900 ml, BioGlue™ achieved complete sealing in nine, six, five, four two and one specimens, respectively. Mean burst pressure was 38.0 ± 4.2 cmH₂O. All sealant failures were cohesive. BioGlue™ allowed an expansion of covered lung defects of 1.5 ± 1.7 mm.

Conclusions

Our in vitro tests demonstrated a high sealing efficacy of BioGlue™ for repair of superficial lung defects. Due to the rigid nature, caution should be taken to use this kind of sealant in trapped lungs.

Abolhoda A, Liu D, Brooks A, Burt M. Prolonged air leak following radical upper lobectomy. Chest. 1998;113(6):1507–10.CrossRefPubMed

Bardell T, Persikas D. What keeps postpulmonary resection patients in hospital. Can Respir J. 2003;10:86–9.CrossRefPubMed

Okereke I, Murthy SC, Alster JM, Blackstone EH, Rice TW. Characterization and importance of air leak after lobectomy. Ann Thorac Surg. 2005;79:1167–73.CrossRefPubMed

Annegg U, Lindenmann J, Matzi V, Smolle J, Maier A, Smolle-Juttner F. Efficiency of fleece bound sealing (TachoSil) of air leaks in lung surgery: a prospective randomised trial. Eur J Cardiothorac Surg. 2007;31:198–202.CrossRef

Belda Sanchís J, Serra-Mitjans M, Iglesias Sentis M, Rami R. Surgical sealant for preventing air leaks after pulmonary resections in patients with lung cancer. Cochrane Database Syst Rev. 2010;1:CD003051.PubMed

Malapert G, Hanna HA, Pages PB, Bernard A. Surgical sealant for the prevention of prolonged air leak after lung resection: meta-analysis. Ann Thorac Surg. 2010;90:1779–85.CrossRefPubMed

Rocco G, Rendina EA, Venuta F, Mueller MR, Halezeroglu S, Dienemann H, et al. The use of sealants in modern thoracic surgery: a survey. Interact Cardiovasc Thoracic Surg. 2009;9:1–3.CrossRef

Zhang R, Bures M, Höffler HK, Zinne N, Langer F, Bisdas T, et al. TissuePatch™ as a novel synthetic sealant for repair of superficial lung defect: in vitro tests results. Ann Surg Innov Res. 2012;6:12.CrossRefPubMedPubMedCentral

Chao HH, Torchiana DF. BioGlue: albumin/glutaraldehyde sealant in cardiac surgery. J Card Surg. 2003;18(6):500–3.CrossRefPubMed

10.

Raanani E, Georghiou GP, Kogan A, Wandwi B, Shapira Y, Vidne BA. BioGlue for the repair of aortic insufficiency in acute aortic dissection. J Heart Valve Dis. 2004;13:734–7.PubMed

11.

Bhamidipati CM, Coselli JS, LaMaire SA. BioGlue in 2011: what is its role in cardiac surgery? J Extra Corpor Technol. 2012;44:6–12.

12.

Tokunaga S, Yasuga S, Masuda M. Devised reinforcement of distal stump in total arch replacement using BioGlue. Asian Cardiovasc Thorac Ann. 2013;22:755–7.CrossRefPubMed

13.

D’Andrilli A, Venuta F, Rendina E. Use of Sealants to Reduce Air Leak Duration and Hospital Stay After Lung Resection. In: Ferguson MK, editor. Difficult Decisions in Thoracic Surgery: An Evidence-Based Approach. London: Springer; 2011. p. 375–83.CrossRef

14.

Macchiarini P, Wain J, Almy S, Dartevelle P. Experimental and clinical evaluation of a new synthetic, absorbable sealant to reduce air leaks in thoracic operations. J Thorac Cardiovasc Surg. 1999;117:751–8.CrossRefPubMed

15.

Varela G, Jinénez MF, Novoa N, Aranda JL. Estimating hospital cost attributable to prolonged air leak in pulmonary lobectomy. Eur J Cardiothorac Surg. 2005;27:329–33.CrossRefPubMed

16.

Potaris K, Mihos P, Gakidis I. Preliminary results with the use of an albumin-glutaraldehyde tissue adhesive in lung surgery. Med Sci Monit. 2003;9:179–83.

17.

Rathinam S, Naidu BV, Nanjaiah P, Loubani M, Kalkat MS, Rajesh PB. BioGlue and Peri-strips in lung volume reduction surgery: pilot randomised controlled trial. J Cardiothorac Surg. 2009;4:37.CrossRefPubMedPubMedCentral

18.

Tansley P, Al Mulhim F, Lim E, Ladas G, Goldstraw P. A prospective, randomized, controlled trial of the effectiveness of BioGlue in treating alveolar air leaks. J Thorac Cardiovasc Surg. 2006;132:105–12.CrossRefPubMed

19.

Allen MS, Wood DE, Hawkinson RW, Harpole DH, McKenna RJ, Walsh GL, et al. Prospective randomized study evaluating a biodegradable polymeric sealant for sealing intraoperative air leaks that occur during pulmonary resection. Ann Thorac Surg. 2004;77:1792–801.CrossRefPubMed

20.

Belcher E, Dusmet M, Jordan S, Ladas G, Lim E, Goldstraw P. A prospective, randomized trial comparing BioGlue and Vivostat for the control of alveolar air leak. J Thorac Cardiovasc Surg. 2010;140:32–8.CrossRefPubMed

21.

Azadani AM, Matthews PB, Ge L, Shen Y, Jhun CS, Guy TS, et al. Mechanical properties of surgical glues used in aortic root replacement. Ann Thorac Surg. 2012;87:1154–60.CrossRef

22.

Fürst W, Banerjee A. Release of Glutaraldehyde From an Albumin-Glutaraldehyde Tissue Adhesive Causes Significant In Vitro and In Vivo Toxicity. Ann Thorac Surg. 2005;79:1522–9.CrossRefPubMed

Title: Albumin-glutaraldehyde glue for repair of superficial lung defect: an in vitro experiment
Authors: Maximilian Bures
Hans-Klaus Höffler
Godehard Friedel
Thomas Kyriss
Enole Boedeker
Florian Länger
Patrick Zardo
Ruoyu Zhang
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: Journal of Cardiothoracic Surgery / Issue 1/2016
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-016-0443-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Albumin-glutaraldehyde glue for repair of superficial lung defect: an in vitro experiment

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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