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Development of Biologically-Inspired Pleural Sealants
Objective: Pneumothorax is a frequently encountered pathology for which treatment has not changed significantly since the advent of the chest tube over 100 years ago. Bronchopleural fistula, a related but less frequent pathology, is difficult to manage and lacks effective treatment options. Currently available pleural sealants are cumbersome and limited in their application to pulmonary resections. Thus, our objective was to develop a novel pleural sealant.
Design: Using an ex vivo porcine lung injury model, we investigated biologically-inspired polymers for use as pleural sealants. Materials such as alginates and chitosan were tailored for application as a liquid or aerosol applied to the pleural surface of the lung, where they were crosslinked to form a solid patch to seal an air leak. Additionally, these materials were applied as pre-formed dry patches to the external surface of an injured lung.
Setting: University of Vermont Medical Center, Biomedical Engineering
Patients: N/A
Interventions: N/A
Main Outcome Measured: Air leak after repair of ex vivo porcine lung injury
Results: The materials tested showed varying degrees of adhesiveness and material strength. Alginate functionalized with dopamine was extremely adhesive to the pleura but lacked optimized material strength. Chitosan functionalized with protocatechuic acid, as well as a combination of oxidized and methacrylated alginates created airtight seals for over 24 hours.
Conclusions: Multiple biopolymers proved effective as pleural sealants. Future directions include application with an in vivo rat surgery model. We also plan to explore other uses for these materials, including reinforcement of gastric staple lines and repair of tracheoesophageal fistulas. Additionally, we are exploring the incorporation of stem cells into these materials to promote wound healing.