title: Comparative study of lung sealants in a porcine ex vivo model.
abstract: BACKGROUND
  Lung sealants are often used to prevent alveolar air leaks after lung resection surgery. Some sealants have shown to be effective in clinical studies, but extensive comparative evaluation has not yet been conducted. We aimed to evaluate different sealant burst pressures in an ex vivo model mimicking air leakage after lung resection.
  
  
  METHODS
  Fifty-four porcine lungs comprised the study material. Six different sealants were evaluated: Bioglue (V-Tech, Roskilde, Denmark), TachoSil (Nycomed, Roskilde, Denmark), Tisseel (Baxter, Allerød, Denmark), Evicel (OMRIX biopharmaceuticals S.A, Rhode-St-Genèse, Belgium), TissuePatchDural (Vingmed, Roskilde, Denmark), and Pleuraseal (Covidien, Copenhagen, Denmark). After creating a standardized pleural defect, each lung was randomized into 1 of the 6 treatment groups (n= 9). Each lung was ventilated with incremental airway pressure. Air leakage was assessed after each increment. If leakage occurred, the burst pressure was recorded.
  
  
  RESULTS
  The Evicel fibrin sealant and Tisseel fibrin sealant exhibited significantly lower burst pressures compared with the Bioglue, TachoSil, and Pleuraseal (p < 0.05). Bioglue had the highest median burst pressure (55 cm H(2)O) followed by TachoSil (35 cm H(2)O), PleuraSeal (35 cm H(2)O), TissuePatchDural (25 cm H(2)O), Evicel (15 cm H(2)O), and Tisseel (15 cm H(2)O).
  
  
  CONCLUSIONS
  This model has shown to be feasible in determining and comparing the burst pressures of different lung sealants. Further studies are needed to determine responses in living tissue and burst pressure over time in vivo.
authors.affiliation: Institute of Clinical Medicine, Aarhus University Hospital, Skejby, Denmark.
authors.forename: Torben B
authors.initials: TB
authors.lastname: Pedersen
authors.forename: Jesper L
authors.initials: JL
authors.lastname: Honge
authors.forename: Hans K
authors.initials: HK
authors.lastname: Pilegaard
authors.forename: J Michael
authors.initials: JM
authors.lastname: Hasenkam
mesh_terms: D000818:Animals; D015718:Fibrin Tissue Adhesive; D066298:In Vitro Techniques; D023421:Models, Animal; D011013:Pneumonectomy / Q000379:methods*; D013552:Swine; D014014:Tissue Adhesives
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives