Development of new biodegradable hydrogel glue for preventing alveolar air leakage.
OBJECTIVE
Air leakage is a frequent complication during lung surgery. A new hydrogel glue was created by mixing aldehyded dextran and epsilon-poly(l-lysine), and its feasibility as a surgical sealant was evaluated in comparison with that of conventional fibrin glue.


METHODS
Bursting pressure after application of each glue to 30 x 30-mm pleuroparenchymal defects was evaluated in two groups of 14 beagle dogs. Biodegradability and histotoxicity of the glues were evaluated in another 6 dogs with 15-mm circular pleuroparenchymal defects. Adhesions, infections, and histologic changes were observed on scheduled days for 6 months.


RESULTS
The mean bursting pressure after application was 38.4 +/- 4.6 cm H2O for the new glue and 32.1 +/- 4.5 cm H2O for fibrin glue (P = .02), the former providing more effective sealing of pulmonary air leakage than the latter. Macroscopically, no adhesions or infections were observed in areas of glue application. About 90% of the new glue degraded within 3 months, but complete disappearance was not observed by 6 months. On the other hand, the fibrin glue was replaced by white pleural tissue at 4 weeks. Histologically, the new glue was covered by one layer of mesothelial cells at 2 weeks and completely covered by thick fibrous tissue at 4 weeks. Inflammatory reaction was minimal around the residual glue after 3 months. Although the new glue degraded more slowly than did the fibrin glue, the biocompatibility of the new glue was sufficient for clinical use.


CONCLUSIONS
Our new hydrogel glue demonstrates a strong sealing effect, with good biocompatibility, and has potential usefulness as an adhesive in lung surgery.
Araki
Masato
M
Department of Bioartificial Organs, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan. masato-araki@frontier.kyoto-u.ac.jp
Tao
Hiroyuki
H
Nakajima
Naoki
N
Sugai
Hajime
H
Sato
Toshihiko
T
Hyon
Suong-Hyu
SH
Nagayasu
Takeshi
T
Nakamura
Tatsuo
T
D000269:Adhesives; D000388:Air; D000447:Aldehydes; D000818:Animals; D001672:Biocompatible Materials; D001684:Biological Dressings; D001696:Biomechanical Phenomena; D003911:Dextrans / Q000008:administration & dosage; D004285:Dogs; D005240:Feasibility Studies; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage; D020100:Hydrogels / Q000008:administration & dosage*; D008171:Lung Diseases / Q000209:etiology / Q000517:prevention & control*; D011107:Polylysine / Q000008:administration & dosage; D011183:Postoperative Complications; D013510:Pulmonary Surgical Procedures / Q000009:adverse effects*; D014014:Tissue Adhesives / Q000008:administration & dosage*
D000269:Adhesives; D000447:Aldehydes; D001672:Biocompatible Materials; D003911:Dextrans; D015718:Fibrin Tissue Adhesive; D020100:Hydrogels; D014014:Tissue Adhesives; D011107:Polylysine