title: Experimental Study of Intraparenchymal Fibrinogen and Topical Thrombin to Seal Pleural Defects.
abstract: OBJECTIVE
  Fibrin sealants are used to close surgical pleural defects, but may detach, causing a postoperative air-leak. We investigated a new means of applying fibrin glue for closing pleural defects.
  
  
  METHODS
  Pleural defects (10-mm and 4-mm diameters, respectively) were created in swine and rats via thoracotomy. They were sealed by a) injection of a fibrinogen solution into the lung parenchyma after instillation of a thrombin solution onto the pleural defect (group A), b) fibrinogen and thrombin spray (group B), c) fibrinogen instillation and a thrombin-dipped polyglycolic acid sheet (group C), or d) fibrin glue-coated collagen fleece (group D). Resistance to airway pressure was compared and the sealed areas were histologically examined.
  
  
  RESULTS
  In group A, the minimum seal-breaking airway pressure was consistently > 40 cmH2O, versus 37.2 ± 3.6 cmH2O in group B, 37.2 ± 4.0 cmH2O in group C, and 39.0 ± 1.7 cmH2O in group D, which was statistically significant. Histologically, the fibrin layer infiltrated the lung parenchyma and covered the defect in group A, but not in the other groups.
  
  
  CONCLUSIONS
  The intraparenchymal injection of fibrinogen combined with instillation of thrombin created an effective fibrin layer associated with early pleural regeneration that reliably prevented pleural air leaks.
authors.forename: Jun
authors.initials: J
authors.lastname: Yamamoto
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. kohno@1993.jukuin.keio.ac.jp.
authors.forename: Mitsutomo
authors.initials: M
authors.lastname: Kohno
authors.forename: Naoko
authors.initials: N
authors.lastname: Izawa
authors.forename: Toshinari
authors.initials: T
authors.lastname: Ema
authors.forename: Tai
authors.initials: T
authors.lastname: Hato
authors.forename: Ikuo
authors.initials: I
authors.lastname: Kamiyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohtsuka
authors.forename: Masazumi
authors.initials: M
authors.lastname: Watanabe
mesh_terms: D057868:Anastomotic Leak / Q000517:prevention & control / Q000628:therapy*; D000818:Animals; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage*; D005340:Fibrinogen / Q000008:administration & dosage*; D007267:Injections; D008297:Male; D023421:Models, Animal; D010994:Pleura; D011183:Postoperative Complications / Q000517:prevention & control / Q000628:therapy*; D017208:Rats, Wistar; D012996:Solutions; D013552:Swine; D013917:Thrombin / Q000008:administration & dosage*
chemical_list: D015718:Fibrin Tissue Adhesive; D012996:Solutions; D005340:Fibrinogen; D013917:Thrombin