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Fleece bound sealing prevents pleural adhesions

^a Department of Cardiothoracic Surgery, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
^b Department of General Surgery and Transplantology, Medical University Vienna, Austria
^c Department of Anatomy and Cell Biology, Medical University Vienna, Austria

*Corresponding author. Tel.: +43 1 40400 5620; fax: +43 1 40400 5680.

E-mail address: michael.mueller{at}meduniwien.ac.at (M.R. Mueller).

This study assessed the value of haemostatic fleece (HF) in prevention of pleural adhesions in an experimental animal model. Forty rats were randomly assigned to four equal groups and underwent bilateral thoracotomy. In Group 1 standardized defects of 5 mm were generated in the visceral and the opposite parietal pleura without further coverage. In Group 2 a 5-mm piece of HF (TachoSil^®) was applied onto the intact pleura. In Group 3 a standardized pleural defect was completely covered by HF. The same kind of defect was only partially covered by HF in group 4 animals. Autopsy at 6 weeks (n=5, each group) revealed the fleece widely unchanged and covered by a smooth serous membrane. After 12 weeks (n=5, each group) the fleece had been completely resorbed. Histological studies revealed the area of the defect covered by regular mesothelium. In all animals pleural adhesions were detected only in the area without fleece coverage. In this experimental model HF prevented the development of pleural adhesions. This property may have clinical impact in patients with some probability of re-thoracotomy enabling to reduce the risk of pleural adhesions significantly.

Key Words: Animal model; Experimental surgery; Haemostatic fleece; Pleural adhesions

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