Kodama K, Doi O, Higashiyama M, Yokouchi H
Department of Thoracic Surgery, Center for Adult Diseases, Osaka, Japan.
Eur J Cardiothorac Surg. 1997 Feb;11(2):333-7. doi: 10.1016/s1010-7940(96)01006-8.
Recently, the use of gelatin-resorcinol formaldehyde-glutaraldehyde (GRFG) glue has been reported in vascular surgery, especially in surgery for acute aortic dissection. However, reports concerning its use in lung surgery are quite rare. Although the strong adhesion and tensile strength of GRFG glue to fresh incisional wounds of the lung has been demonstrated experimentally, the effectiveness of this adhesive on thermal injury with severe tissue degeneration has not yet been reported.
We experimentally evaluated the ability of GRFG glue to seal air leaks through severely degenerated tissues after thermal injury on rat lung, and compared its performance with two reference adhesives: fibrin glue and EDH-adhesive.
The GRFG glue provided complete pneumostasis immediately after the sealing in the presence of positive pressure ventilation, unlike the other two reference adhesives. The fate and biocompatibility of the three glues were examined histologically at 1 h and 3, 8, and 20 days after treatment. The GRFG glue tightly adhered to the degenerated tissue surface and was gradually fragmented and absorbed. The healing process was favorable, indicating good biocompatibility. Local tissue irritability was negligible.
Even in the presence of tissue degeneration and positive pressure ventilation, the GRFG glue has proved efficacious as a surgical adhesive in lung surgery because of its ability to bind tissue rapidly and tightly.
最近，有报道称在血管外科手术中，尤其是急性主动脉夹层手术中使用了明胶 - 间苯二酚 - 甲醛 - 戊二醛（GRFG）胶水。然而，关于其在肺手术中应用的报道却相当罕见。尽管实验已证明GRFG胶水对肺新鲜切口创面具有较强的黏附力和拉伸强度，但这种粘合剂在伴有严重组织变性的热损伤方面的有效性尚未见报道。
我们通过实验评估了GRFG胶水封堵大鼠肺热损伤后严重变性组织漏气的能力，并将其性能与两种对照粘合剂：纤维蛋白胶和EDH粘合剂进行比较。
与其他两种对照粘合剂不同，在正压通气情况下，GRFG胶水封堵后立即实现了完全的肺静态。在治疗后1小时以及3、8和20天，通过组织学检查了三种胶水的转归和生物相容性。GRFG胶水紧密粘附于变性组织表面，并逐渐破碎和吸收。愈合过程顺利，表明生物相容性良好。局部组织刺激性可忽略不计。
即使存在组织变性和正压通气，GRFG胶水因其能够快速紧密地粘合组织，已被证明在肺手术中作为手术粘合剂是有效的。
