Prevention of postoperative air leakage from lungs using a purified human collagen membrane–polyglycolic acid sheet

doi:10.1016/S0003-4975(99)00567-6

The Annals of Thoracic Surgery

Volume 68, Issue 2, August 1999, Pages 339-342

https://doi.org/10.1016/S0003-4975(99)00567-6 Get rights and content

Abstract

Background. Human amnion has useful biomedical applications because it contains a large amount of human collagen fibers. We prepared purified human collagen membrane (HCM) from human amnion and used it to develop a new sheet by combining it with synthetic bioabsorbable polyglycolic acid (PGA) mesh. We evaluated its efficacy in preventing air leakage from the lungs of dogs.

Methods. In 20 dogs, HCM-PGA sheet (n = 5), sheets using fibrin glue with a separate application method (n = 5), a mixed application method (n = 5), and fibrin glue alone (n = 5), were used as dressing materials after partial lung resection.

Results. The HCM-PGA sheet using fibrin glue with a separate application method was shown to be significantly more effective by an air leakage pressure test than the other three methods. These results indicate that the HCM-PGA sheet is useful for preventing air leakage from the lung.

Conclusions. The HCM-PGA sheet is more effective than conventional fibrin glue for controlling postoperative air leakage.

Section snippets

Material and methods

Amniotic membrane along with chorionic membrane was obtained from freshly delivered human placenta, and the two membranes were separated by stripping. To eliminate the antigenicity of the membrane, the surface cells were removed by treatment with 0.1% ficin. The membrane was then rinsed with phosphate buffer solution. Polyglycolic acid mesh with a pore size of 0.89 × 0.97 mm was immersed in 2.5% gelatin solution, and the membrane was then pasted on both surfaces of the mesh to give a

Prevention of air leakage

Before repair of the partial resection defects, air leakage began at an airway pressure of 10 to 15 cm H₂O. The airway pressure at which air leakage began at the defect was defined as the air leakage pressure in this study. In the HCM-PGA sheet group, the air leakage pressure (mean ± standard deviation) was 40.0 ± 0.00 cm H₂O. The prevention of air leakage was quite satisfactory (Fig 3). In the HCM-PGA sheet plus fibrin glue group, the air leakage pressure was 39.0 ± 5.48 cm H₂O for the mixed

Comment

Human amnion is a promising biomaterial and is contained in freshly delivered human placenta. Such collagen membranes have been used to prevent adhesion of the pelvic peritoneum 1, 2, 3, intestine [4], pericardium [5], or vagina 6, 7, 8, 9.

The final form of the fetal membrane is an inner amniotic membrane consisting of a single layer of ectodermally derived amnion cells fixed firmly to a collagen-rich mesenchymal layer six to eight cells thick, which is loosely attached to the chorion,

Acknowledgements

We are grateful to Yasuyuki Kitagawa and Minako Ishii for their assistance. This study was supported by a grant from the Japan Society for the Promotion of Science, “Research for the Future” program, JSPS-RFTF 96100203.

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We previously reported the stump closure method for the remnant pancreas in distal pancreatectomy, in which soft coagulation and polyglycolic acid felt attached with fibrin glue were utilized. Transpancreatic mattress suture with polyglactin 910 woven mesh was recently reported as a novel stump closure technique. We developed the modified transpancreatic mattress suture with polyglactin 910 woven mesh method, which combined our polyglycolic acid felt method with the transpancreatic mattress suture with polyglactin 910 woven mesh method.
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Original ArticlesPrevention of postoperative air leakage from lungs using a purified human collagen membrane–polyglycolic acid sheet

Abstract

Section snippets

Material and methods

Prevention of air leakage

Comment

Acknowledgements

Fertil Steril

Amniotic membrane wrappingan alternative method to the splenorrhaphy in the injured spleen

Eur J Pediatr Surg

Use of fetal membranes as replacement for pelvic peritoneum after pelvic exenteration in the dog

Surg Forum

Repair of prenatally ruptured omphalocele and the paraumbilical abdominal wall defect with the infant’s own fetal membranes

Münchener Medizinische Wochenschrift

Human amniotic membrane as an intestinal patch for neomucosal growth in the rabbit model

J Pediatr Surg

A new biological membrane for pericardial closure

J Biomed Material Res

Original Articles
Prevention of postoperative air leakage from lungs using a purified human collagen membrane–polyglycolic acid sheet