The optimal technique for combined application of fibrin sealant and bioabsorbable felt against alveolar air leakage
Eur J Cardiothorac Surg Itano
33: 457
On-line Video
Files in this Data Supplement:
- Video 1
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Video 1 (.rv format). The experimental procedure in Group III: the Rub + Soak B method. (1) Creation of pleural defects. (2) Impregnation of the polyglycolic acid felt with the thrombin solution. (3) Rubbing of the fibrinogen solution over the defect.
(4) Attachment of the thrombin-soaked sheets. (5) Alternate application of the remaining amounts (half the original) of the fibrinogen and thrombin solutions. (6) Immersion of the lung in normal saline followed by gradual increase in the airway pressure.
- Video 2
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Video 2 (.rm format). The sealing mechanism in Group III: the Rub + Soak B method. (1) Rubbing of the fibrinogen solution and its penetration into the tissue. (2) Attachment of the thrombin-soaked felt sheets A: The less-viscous thrombin solution penetrates the tissue and forms a fibrin clot within it; this clot functions like a foothold that fixes the covering materials to the lung tissue. B: On attaching the thrombin-impregnated felt on the area rubbed with fibrinogen,@the fibrinogen solution is partially soaked up by the lining layer of the felt sheet through capillary action. This absorbed fibrinogen interacts with the thrombin in the felt fibers and forms a fibrin clot that fills the microspaces in the lower layer of the felt, thereby leaving minimal air spaces. (3) Application of the remaining half of the fibrinogen solution leads to the filling of the entire layer of felt by the clot. (4) Integration of the lung tissue, felt fibers, and fibrin clot
A: The air spaces within the sheet are completely filled with the clot. B: The felt fibers are completely integrated into the clot layer like a framework. C: Fixation of the clot layer to the tissue via the foothold.