Bellotto F, Johnson R G, Weintraub R M, Foley J, Thurer R L
Division of Cardiothoracic Surgery, Beth Israel Hospital, Harvard Medical School, Boston, Massachusetts.
Surg Gynecol Obstet. 1992 Mar;174(3):221-4.
Peripheral bronchopulmonary fistulas, or parenchymal air leaks, may occasionally be resistant to conventional suture or stapling techniques. In such instances, the tissue is poor and the associated morbidity of a persistent leak will be the greatest. We tested a previously described tissue adhesive compounded from gelatin resorcinol and polymerized at the time of application with a glutaraldehyde-formaldehyde mixture. We evaluated the ability of the adhesive to seal incisional air leaks acutely in the lungs of rabbits under conditions of positive intratracheal pressure and persistent ventilation. We also tested the efficacy of the glue at intervals after compounding to assess the shelf life of this nonproprietary formula. We established a technique for application of this adhesive and demonstrated its ability to decrease consistently the magnitude of air leaks, while generally providing complete pneumostasis in the presence of clinically relevant positive pressure ventilation. We conclude that this material can be prepared months in advance of its occasional use as an effective means of dealing with parenchymal air leaks encountered at operation.
