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Novel biodegradable powder for preventing postoperative pleural adhesion.
Katsunori Takagi1, Tomoshi Tsuchiya, Masato Araki
1Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8501, Japan. dm08009e@cc.nagasaki-u.ac.jp
The Journal of Surgical Research
|April 10, 2012
Summary
A new aldehyde dextran and ε-poly(L-lysine) powder (D-L powder) effectively prevents pleural adhesions after surgery. This novel agent offers easier administration during video-assisted thoracic surgery compared to existing options.
Area of Science:
- Thoracic Surgery
- Biomaterials Science
- Surgical Adhesion Prevention
Background:
- Polysurgery is increasing due to medical advancements, leading to challenges with postoperative pleural adhesions.
- Pleural adhesions can complicate subsequent surgeries, causing poor visualization, bleeding, and tissue trauma.
- Currently, no ideal anti-adhesive agents exist to prevent pleural adhesions effectively.
Purpose of the Study:
- To evaluate the anti-adhesive efficacy of existing agents (Seprafilm, Interceed) and a novel powder-type agent (aldehyde dextran and ε-poly(L-lysine) powder, D-L powder).
- To compare the effectiveness of these agents in preventing pleural adhesions in a rat model.
Main Methods:
- A thoracotomy was performed on 48 male rats, randomized into four groups: normal saline (control), Seprafilm, Interceed, and D-L powder.
- Animals were euthanized on Day 7 or Day 28 to assess adhesion severity, length, and gross and pathological appearance.
- The usability of D-L powder was demonstrated in video-assisted thoracic surgery in pigs.
Main Results:
- D-L powder significantly reduced adhesion length compared to the control group on both Day 7 and Day 28 (P < 0.05).
- On Day 28, only Interceed remained on the lung surface, with associated small vessel presence.
- D-L powder proved easy to administer via a trocar sleeve during porcine video-assisted thoracic surgery.
Conclusions:
- D-L powder demonstrates significant effectiveness in preventing postoperative pleural adhesions.
- While Seprafilm and Interceed show some efficacy, D-L powder offers superior ease of administration, particularly in minimally invasive thoracic procedures.
