Application Of Polyglycolic Acid Sheet Research Articles

Pulmonary cyst newly formed after lobectomy in various underlying lung conditions

BackgroundIt has been recently recognized that pulmonary cyst may develop after pulmonary resection, causing various symptoms. Most previously reported cases were after upper lobectomy in patients with chronic obstructive lung disease (COPD).Case presentationCase 1 was a man in his 70 s with interstitial pneumonia (IP). Right lower lobectomy was performed for metastatic lung tumor using video-assisted thoracoscopic surgery (VATS). On postoperative day (POD) 19, computed tomography (CT) revealed a large cyst at the upper interlobular surface of the middle lobe, with pneumoderma and pneumomediastinum. The cyst was incised, polyglycolic acid (PGA) sheet and fibrin glue were applied, and the cyst was sutured. The sutured line was covered again with PGA sheet and fibrin glue. Case 2 was a man in his 70 s with COPD. Right upper lobectomy for primary lung cancer was performed using VATS. On POD 17, CT revealed a large pulmonary cyst at the apex of S6 and massive air leakage was observed. The same surgical procedure as that used in case 1 was performed. Cases 3 and 4 were healthy donors for living-donor lung transplantation. Two months after the right lower lobectomy in Case 3 and 3 months after the left lower lobectomy in Case 4, the patients had respiratory symptoms such as dyspnea and hemosputum. CT revealed a large cyst on the diaphragmatic surface of the right middle lobe in Case 3 and on the posterior mediastinal surface of the left upper lobe in Case 4. Cyst incision, soft coagulation, and application of PGA sheet with fibrin glue were performed in both cases. CT performed 1 year after surgery showed no development of a pulmonary cyst or air space in these four cases.ConclusionsPulmonary cysts newly formed after lobectomy can develop not only in COPD or IP but also in healthy lungs. Our findings suggest that incision of the cyst and application of fibrin glue and PGA sheet with or without suturing the cyst wall is effective for management.

Application of polyglycolic acid sheets and basic fibroblast growth factor to prevent esophageal stricture after endoscopic submucosal dissection in pigs.

Endoscopic submucosal dissection (ESD) has been the first-line treatment for early-stage esophageal cancer. However, it often causes postoperative stricture in cases requiring wide dissection. Basic fibroblast growth factor (bFGF) reportedly has anti-scarring effects during cutaneous wound healing. We hypothesized that suppressing myofibroblast activation will prevent stricture after esophageal ESD. We resected a complete porcine esophagus circumference section by ESD. To investigate the preventive effect of bFGF on esophageal stricture formation after ESD, we endoscopically applied bFGF-soaked poly-glycolic acid (PGA) sheets onto the wound bed after ESD and fixed them by spraying fibrin glue (PGA + bFGF group), PGA sheets alone onto the wound bed and fixed them by spraying fibrin glue (PGA group), or nothing (control group). After removing the esophagus on day 22, we evaluated the mucosal constriction rate. Compared with those in the control group, esophageal stricture was significantly reduced in the PGA + bFGF group, and the areas stained with α-SMA and calponin-1 antibodies were significantly inhibited in the PGA + bFGF and PGA groups. The thickness of the fibrous layer in the PGA + bFGF group was uniform compared to that of the other groups. Thus, PGA + bFGF inhibited the development of unregulated fibroblasts in the acute phase, leading to uniform wound healing. Stenosis after esophageal ESD is related to fibrosis in the acute phase. Administration of PGA and bFGF suppresses myofibroblast activation in the acute phase, thereby preventing esophageal constriction in pigs.

Comparison of Postoperative Bleeding between Application of Polyglycolic Acid Sheet and Primary Closure in Tongue Cancer Patients with Partial Glossectomy.

The technique of covering a mucosal defect with fibrin glue and a polyglycolic acid sheet (MCFP) for the resection of mucosa is applied in oral cancers. The MCFP technique for partial glossectomy provides faster relief from postoperative pain and the prevention of scar contracture, unlike primary closure. However, it has a major complication of postoperative bleeding. This study sought to compare postoperative bleeding between the MCFP technique and primary closure. We designed a retrospective study with a cohort of 57 patients who underwent partial glossectomy with the MCFP technique or primary closure. Our primary predictor variable was the wound closure procedure (primary closure or the MCFP technique). The primary outcome variable was postoperative bleeding, and the other variables were patient characteristics, excision area and depth, tooth contact for the wound, and antithrombotic therapy. Statistical evaluation was performed with Pearson’s chi-squared test, Welch’s t-test, and multiple logistic regression. P < 0.05 was considered statistically significant. The MCFP technique was selected for cases with a large excision area (1433 vs. 963 mm2, P = 0.029). Total postoperative bleeding occurred in 10 of 57 patients (MCFP technique: 7 of 37 cases; primary closure: 3 of 20 cases). There was no significant difference in bleeding between the two groups (P = 0.71). Postoperative bleeding was significant in patients with antithrombotic therapy (MCFP: 40% vs. primary closure: 2%, P = 0.0024). Postoperative bleeding timing was significantly different in the MCFP technique (6.4 days) from that of primary closure (1 day; P = 0.0076). Postoperative bleeding was not associated with the MCFP technique or primary closure. However, postoperative bleeding with the MCFP technique occurred later than that with primary closure. The MCFP technique is not recommended for patients on antithrombotic therapy.

Endoscopic closure of refractory esophageal fistula after esophagectomy using polyglycolic acid sheets: a pilot study.

Background and study aims Esophageal fistulas after esophagectomy are associated with high mortality and poor quality of life. They are sometimes intractable to conservative management and surgery that increases mortality. Few studies have assessed use of polyglycolic acid (PGA) sheets with fibrin glue for esophageal fistulas. We investigated the safety of using PGA sheets with fibrin glue for esophageal fistulas after esophagectomy. Patients and methods This was a single-center prospective pilot study. Patients who had refractory esophageal fistulas after esophagectomy were included. PGA sheets were filled in the fistula using biopsy forceps. Fibrin glue was applied to the PGA sheets. We repeated the procedure 1 week later. The outcome measures were the incidence of adverse events (AEs) and closure of the fistula. Results Five patients were assessed. No adverse events were observed. The esophageal fistula was closed with the application of PGA sheets four times in 40 % (2/5) of the cases. Conclusions PGA sheets with fibrin glue were safe for esophageal fistula closure after esophagectomy and do not involve the risk of AEs.

Clinical complications in the application of polyglycolic acid sheets with fibrin glue after resection of mucosal lesions in oral cavity

Covering open wounds with a polyglycolic acid (PGA) sheet using fibrin glue after resection of oral mucosal lesions is reportedly useful. We focused on clinical complications of this procedure: development of marked granuloma-like neoplasm (GLN) and abnormal postoperative bleeding (APB) on the resected region. The characteristics of 100 cases with PGA sheet application after the resection of oral mucosal lesion were examined retrospectively by the medical records and/or oral photographs at our department between 2010 and 2016. Our retrospective analysis identified included 8 cases of GLN development and 7 cases of APB. There was a significantly higher risk of GLN development when the PGA sheet was applied to the raw surface of the tongue. There were no immediate APBs, but 4 APBs occurred several hours after surgery. All APB cases involved the tongue. Both GLNs and APBs are minor complications. Although all cases of GLNs did not involve the recurrence of a tumor, follow-up with incisional or excisional biopsy should be performed. APB in the oral cavity induced by the PGA sheet peeling due to fluctuating adhesive force of the PGA sheets and fibrin glue can sometimes induce life-threatening events.

Experimental study and clinical application of polyglycolic acid sheet with fibrin glue for oral soft tissue surgery

ObjectiveThe purpose of the present study was to examine the effects of a Polyglycolic acid (PGA) sheet with fibrin glue in the prevention of scar shrinkage. MethodsA PGA sheet with fibrin glue was grafted into the tongue after partial glossectomy in 25 rabbits. The wounds were examined histologically and compared to those of animals without grafts at 1, 2, 4, and 8 weeks after surgery, with particular focus on the change in the shape of the tongue and scar shrinkage. Furthermore, a retrospective study was conducted for cases in which the material was grafted into the raw surface of the tongue after partial glossectomy in 20 patients with early tongue cancer or leukoplakia. Postoperative pain and bleeding, and functional disadvantages were compared between the patients with PGA grafts and 6 patients that received partial glossectomy followed by a collagen-based artificial dermis graft. ResultsIn the animal experiment, less scar shrinkage was observed in rabbits receiving the graft of the PGA sheet with fibrin glue than in those with an open wound. Clinical application of the PGA sheet with fibrin glue indicated that the materials could prevent postoperative pain and functional disadvantages compared to collagen-based artificial dermis, although no statistical analysis was conducted on these results because of a historical controlled study with a small number of patients. ConclusionsThe results of this study suggest that a PGA sheet with fibrin glue is useful for treating an open wound after soft tissue surgery of the oral cavity.

Successful closure of a large perforation during colorectal endoscopic submucosal dissection by application of polyglycolic acid sheets and fibrin glue

Successful closure of a large perforation during colorectal endoscopic submucosal dissection by application of polyglycolic acid sheets and fibrin glue

Application of Polyglycolic Acid Sheets and Fibrin Glue Spray to Bone Surfaces During Oral Surgery: A Case Series

Previous studies have described the use of a combination of polyglycolic acid (PGA) sheets (a resorbable biomaterial) and fibrin glue spray to treat open soft tissue wounds during oral surgery, which have produced good results. However, there have not been any detailed investigations of the use of these materials to treat exposed hard tissue wounds. This study investigated the combination of PGA sheets and fibrin glue spray to treat exposed bone surfaces during oral surgery. PGA sheets and fibrin glue spray were applied to exposed bone surfaces after lesion resection in 8 patients (10 sites) who had been diagnosed with malignant tumors. The sheets were cut into pieces (width, 5 to 10 mm) and applied to the exposed bone surface. PGA adhesion was confirmed for the final time on postoperative days 28 to 56 (mean, 35.8 days), and there were no cases in which the PGA sheets fell off the wound prematurely. Epithelialization of the wound surface occurred gradually and was complete by postoperative weeks 4 to 5, regardless of the size of the wound. This method was considered very effective at preventing postoperative bleeding, alleviating postoperative pain, and promoting epithelialization during the reconstruction of bone surfaces after tumor resection in the oral cavity.

Application of polyglycolic acid sheet and fibrin glue to treatment of supraglottic stenosis : A case report

Application of polyglycolic acid sheet and fibrin glue to treatment of supraglottic stenosis : A case report

Extended application of polyglycolic acid sheet combined with sprayed fibrin glue to locally advanced oral cancers

Extended application of polyglycolic acid sheet combined with sprayed fibrin glue to locally advanced oral cancers

Clinical Evaluation of Application of Polyglycolic Acid Sheet and Fibrin Glue Spray for Partial Glossectomy

The aim of this study was to evaluate the usefulness of covering open wounds with a polyglycolic acid (PGA) sheet and a fibrin glue spray after partial glossectomy. We clinically evaluated postoperative pain and scar contracture in 44 patients who underwent partial glossectomy followed by covering with a PGA sheet and a fibrin glue spray (PGA sheet group), as compared with 29 patients who were closed primarily (primary closure group). Duration of nonsteroidal anti-inflammatory drugs was almost the same between the PGA sheet group and the primary closure group. The degree of scar contracture was mild in many cases in both groups. In the case in which the excision area was wide and depth was shallow, there was a tendency for the scar contracture to be less in the PGA sheet group. Our findings showed that the use of a PGA sheet and fibrin glue spray for open wounds resulting from partial glossectomy was useful in terms of rapid relief from postoperative pain and prevention of scar contracture.

Clinical application of polyglycolic acid sheet after resection of tongue squamous cell carcinoma

ObjectiveA polyglycolic acid (PGA) sheet has recently been introduced for wound repair in pulmonary surgery and neurosurgery. In this study, we applied a PGA sheet to an open wound following resection of a squamous cell carcinoma (SCC) in the tongue and achieved good healing. We compared the effectiveness of this PGA sheet with that of an artificial dermis (AD) for open wound repair following the SCC resection. Patients and methodsWe evaluated consecutively diagnosed patients who visited the Oral and Maxillofacial Surgery Clinic of our Hospital from January 2007 to March 2011. The patients were divided into two groups, one group using a PGA sheet (PGA group) and one group using an AD (AD group). Operative time, postoperative pain, days of hospitalization, and the presence or absence of postoperative bleeding were compared between the two groups. ResultsThe PGA group showed significantly shorter operative time and significantly less pain than the AD group. Days of hospitalization and postoperative bleeding were not significantly different between the two groups. ConclusionA PGA sheet was found to achieve good wound healing after resection of tongue SCC, and was useful for maintaining the quality of life of patients.

Application of polyglycolic acid sheet (Neoveil®) and fibrin glue spray (Bolheal®) for open wounds in oral surgery

Application of polyglycolic acid sheet (Neoveil®) and fibrin glue spray (Bolheal®) for open wounds in oral surgery

P240. Extended application of polyglycolic acid sheet combined with sprayed fibrin glue to advanced oral cancers

P240. Extended application of polyglycolic acid sheet combined with sprayed fibrin glue to advanced oral cancers

舌部分切除術におけるポリグリコール酸シートおよびフィブリン糊スプレーの使用経験 —コラーゲン使用人工皮膚との比較—

舌部分切除術におけるポリグリコール酸シートおよびフィブリン糊スプレーの使用経験 —コラーゲン使用人工皮膚との比較—