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Related Experiment Videos

Mesh insertion as an aid for pleurodesis.

W M Sugarmann1, W D Widmann, D Mysh

  • 1Department of Surgery, Columbia University College of Physicians and Surgeons, Morristown Memorial Hospital, USA.

The Journal of Cardiovascular Surgery
|December 1, 1996
PubMed
Summary
This summary is machine-generated.

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Combining absorbable mesh (polyglactin) insertion with pleural abrasion effectively achieves predictable pleurodesis for pneumothorax treatment. This adjunct to video-assisted thoracic surgery (VATS) shows promising clinical success.

Area of Science:

  • Thoracic Surgery
  • Surgical Innovation
  • Biomaterials in Medicine

Background:

  • Video-assisted thoracic surgery (VATS) for pneumothorax has seen increased failure rates due to inadequate pleurodesis.
  • Prior studies have not investigated mesh use within the thoracic cavity for pleurodesis.

Purpose of the Study:

  • To evaluate mesh insertion (absorbable and non-absorbable) with or without pleural abrasion for predictable pleurodesis.
  • To assess the efficacy of mesh and abrasion as an adjunct to VATS for pneumothorax treatment.

Main Methods:

  • Rats were used to study the effects of intra-thoracic absorbable polyglactin (Vicryl) and non-absorbable polypropylene (Marlex) mesh.
  • Combinations of mesh insertion and pleural abrasion were compared for adhesion formation at various time points.

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Main Results:

  • Polyglactin mesh alone resulted in transient, filmy adhesions.
  • Polypropylene mesh induced a dense pleural reaction (fibrothorax), unsuitable for clinical use.
  • Pleural abrasion alone yielded variable and often inadequate adhesions.
  • Polyglactin mesh combined with pleural abrasion produced appropriate, firm adhesions in 7/8 rats at 3-4 months.

Conclusions:

  • Absorbable polyglactin mesh combined with pleural abrasion provides predictable and appropriate pleurodesis.
  • This combined technique is a successful adjunct to VATS for pneumothorax treatment, with positive initial clinical applications.