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J Thorac Cardiovasc Surg 2007;134:1241-1248
© 2007 The American Association for Thoracic Surgery

Evolving Technology

Development of new biodegradable hydrogel glue for preventing alveolar air leakage

Masato Araki, MDa,c,*, Hiroyuki Tao, MD, PhDa, Naoki Nakajima, PhDb, Hajime Sugai, BEngb, Toshihiko Sato, MDa, Suong-Hyu Hyon, PhDb, Takeshi Nagayasu, MD, PhDc, Tatsuo Nakamura, MD, PhDa

a Department of Bioartificial Organs, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
b Department of Medical Simulation Engineering, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
c Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

Received for publication March 16, 2007; revisions received July 20, 2007; accepted for publication July 26, 2007.

* Address for reprints: Masato Araki, Department of Bioartifical Organs, Institute for Frontier Medical Sciences, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan. (Email: masato-araki{at}frontier.kyoto-u.ac.jp).

Objective: Air leakage is a frequent complication during lung surgery. A new hydrogel glue was created by mixing aldehyded dextran and {varepsilon}-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.

Conclusion: Our new hydrogel glue demonstrates a strong sealing effect, with good biocompatibility, and has potential usefulness as an adhesive in lung surgery.






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