The influence of pulmonary staple line reinforcement on air leaks.
OBJECTIVE
Although uncommon, prolonged postoperative air leaks are a troublesome complication of lung surgery. This study was performed to determine if buttressing pulmonary staple lines would reduce air leakage at varying airway pressures, and if there was a difference between buttressing materials.


METHODS
Using cadaver lungs, the development of air leak from staple lines was evaluated at incremental airway pressures. Unreinforced staples were compared to staples reinforced with bovine pericardium and staples reinforced with expanded polytetrafluorethylene (ePTFE).


RESULTS
Unreinforced staple lines began to leak air at an airway pressure of 20 mm Hg, and > 90% leaked at a pressure of 35 mm Hg. Both bovine pericardium and ePTFE significantly reduced the incidence of air leak at these airway pressures. At higher airway pressures, ePTFE was superior to bovine pericardium.


CONCLUSIONS
Staple line reinforcement with either material protects against air leak. Patients at risk for elevated airway pressures and/or postoperative ventilator support should be considered for utilization of these staple reinforcing materials.
Murray
Kevin D
KD
Department of Surgery, University of Nevada School of Medicine, 2040 W. Charleston Boulevard, Suite 601, Las Vegas, NV 89102, USA. kmurray@med.unr.edu
Ho
Chih-Hsiang
CH
Hsia
Jiun-Yi James
JY
Little
Alex G
AG
D000328:Adult; D000388:Air; D006801:Humans; D008168:Lung / Q000601:surgery*; D010496:Pericardium; D011138:Polytetrafluoroethylene / Q000494:pharmacology; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D013537:Sutures
D011138:Polytetrafluoroethylene