scholarly journals Functional Adhesion of Pectin Biopolymers to the Lung Visceral Pleura

Polymers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 2976
Author(s):  
Yifan Zheng ◽  
Aidan F. Pierce ◽  
Willi L. Wagner ◽  
Hassan A. Khalil ◽  
Zi Chen ◽  
...  
Keyword(s):  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Citrus Pectin ◽  
Pressure Sensitive Adhesives ◽  
Air Leaks ◽  
Pulmonary Surgery ◽  
Pressure Sensitive ◽  
Pleural Surface ◽  
Pleural Abrasion ◽  
Lung Injuries

Pleural injuries and the associated “air leak” are the most common complications after pulmonary surgery. Air leaks are the primary reason for prolonged chest tube use and increased hospital length of stay. Pectin, a plant-derived heteropolysaccharide, has been shown to be an air-tight sealant of pulmonary air leaks. Here, we investigate the morphologic and mechanical properties of pectin adhesion to the visceral pleural surface of the lung. After the application of high-methoxyl citrus pectin films to the murine lung, we used scanning electron microscopy to demonstrate intimate binding to the lung surface. To quantitatively assess pectin adhesion to the pleural surface, we used a custom adhesion test with force, distance, and time recordings. These assays demonstrated that pectin–glycocalyceal tensile adhesive strength was greater than nanocellulose fiber films or pressure-sensitive adhesives (p < 0.001). Simultaneous videomicroscopy recordings demonstrated that pectin–glycocalyceal adhesion was also stronger than the submesothelial connective tissue as avulsed surface remnants were visualized on the separated pectin films. Finally, pleural abrasion and hyaluronidase enzyme digestion confirmed that pectin binding was dependent on the pleural glycocalyx (p < 0.001). The results indicate that high methoxyl citrus pectin is a promising sealant for the treatment of pleural lung injuries.

Safety of Outpatient Chest Tube Management of Air Leaks after Pulmonary Resection

2015 ◽  
Vol 81 (8) ◽  
pp. 760-763 ◽  
Author(s):  
Anna M. Royer ◽  
Jeremy S. Smith ◽  
Ashley Miller ◽  
Marlana Spiva ◽  
Jenny M. Holcombe ◽  
...  
Keyword(s):  
Chest Tube ◽  
Pulmonary Resection ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Mortality Data ◽  
Patient Demographics ◽  
Air Leaks ◽  
Water Seal ◽  
Hospital Days ◽  
Discharge Criteria

Prolonged air leaks are the most common postoperative complication following pulmonary resection, leading to increased hospital length of stay (LOS) and cost. This study assesses the safety of discharging patients home with a chest tube (CT) after pulmonary resection. A retrospective review was performed of a single surgeon's experience with pulmonary resections from January 2010 to January 2015. All patients discharged home with a CT were included. Discharge criteria included a persistent air leak controlled by water seal, resolution of medical conditions requiring hospitalization, and pain managed by oral analgesics. Patient demographics, type of resection, LOS, and 30-day morbidity and mortality data were analyzed. Comparisons were made with the Society of Thoracic Surgery database January 2011 to December 2013. Four hundred ninety-six patients underwent pulmonary resection. Sixty-five patients (13%) were discharged home postoperatively with a CT. Fifty-eight patients underwent a lobectomy, two patients a bilobectomy, and five patients had a wedge excision. Two patients were readmitted: One with a lower extremity deep venous thrombosis and the other with a nonlife threatening pulmonary embolus. Four patients developed superficial CT site infections that resolved after oral antibiotics. Patients discharged home with a CT following lobectomy had a shorter mean LOS compared to lobectomy patients (3.65 vs 6.2 days). Mean time to CT removal after discharge was 4.7 days (range 1–22 days) potentially saving 305 inpatient hospital days. Select patients can be discharged home with a CT with reduced postoperative LOS and without increase in major morbidity or mortality.

Intraoperative Implementation of a Tissue Sealant on All Lung Surgery Patients: A Quality Improvement Project

2015 ◽  
Vol 8 (1) ◽  
pp. 125-129
Author(s):  
Stephanie Cain ◽  
Richard Anderson ◽  
Patricia Stockert ◽  
Suzanne Brown ◽  
Jane Blood-Siegfried
Keyword(s):  
Length Of Stay ◽  
Chest Tube ◽  
Length Of Hospital Stay ◽  
Clinical Problem ◽  
Hospital Length Of Stay ◽  
Air Leak ◽  
Improvement Project ◽  
Air Leaks ◽  
Pulmonary Surgery ◽  
Tissue Sealant

More than 200,000 patients undergo pulmonary surgery annually. Air leaks after pulmonary surgery are a common complication and represent a substantial clinical problem. Air leaks can increase chest tube time, increase pain, reduce mobility, and increase hospital length of stay. The application of a synthetic surgical lung sealant (SLS) to lung surfaces during surgery in patients at risk for an air leak has been advocated to reduce these complications.The aim of the project was to reduce or eliminate air leaks, decrease chest tube time, and decrease length of stay by applying an FDA-approved tissue sealant during all pulmonary surgeries. The population of focus were adult pulmonary surgery patients undergoing pulmonary surgery.Data were collected on 146 patients: 72 patients the year prior to the intervention and 74 the year after implementation of the intervention. The incidence of air leak was significantly lower; the number of comorbidities was statistically higher in the group following implementation. There were, however, no significant differences in chest tube duration and length of hospital stay. The use of lung sealant on all patients undergoing pulmonary surgery had a positive outcome without any adverse effects and is now standard of practice.

Carotid endarterectomy following thrombolysis for acute ischaemic stroke

VASA ◽  
2017 ◽  
Vol 46 (2) ◽  
pp. 116-120 ◽  
Author(s):  
Naz Ahmed ◽  
Damian Kelleher ◽  
Manmohan Madan ◽  
Sarita Sochart ◽  
George A. Antoniou
Keyword(s):  
Ischaemic Stroke ◽  
Carotid Endarterectomy ◽  
Acute Ischaemic Stroke ◽  
Intravenous Thrombolysis ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Wound Complications ◽  
Cardiac Complications ◽  
High Dependency ◽  
Low Incidence

Abstract. Background: Insufficient evidence exists to support the safety of carotid endarterectomy (CEA) following intravenous thrombolysis (IVT) for acute ischaemic stroke. Our study aimed to report a single-centre experience of patients treated over a five-year period. Patients and methods: Departmental computerised databases were interrogated to identify patients who suffered an ischaemic stroke and subsequently underwent thrombolysis followed by CEA. Mortality and stroke within 30 days of surgery were defined as the primary outcome end points. Results: Over a five-year period, 177 out of a total of 679 carotid endarterectomies (26 %) were performed in patients presenting with acute ischaemic stroke. Twenty-five patients (14 %) received IVT prior to CEA in the form of alteplase. Sixty percent of patients were male with a mean age of 68 years. Sixteen patients (64 %) underwent CEA within 14 days of IVT and the median interval between thrombolysis and CEA was 7.5 days (range, 3–50 days). One female patient died of a further intraoperative stroke within 30 days of surgery, yielding a mortality rate of 4 %. Two patients (8 %) suffered from cardiac complications postoperatively resulting in a short high dependency unit stay. Another two patients (8 %) developed local wound complications, which were managed conservatively without the need for re-operation. The median hospital length of stay was 4.5 days (range, 1–33 days). Conclusions: Our experience indicates that CEA post-thrombolysis has a low incidence of mortality. Further high quality evidence is required before CEA can be routinely recommended following IVT for acute ischaemic stroke.

Passivation of pressure sensitive adhesive stickies by addition of acrylic fibers to OCC pulp before papermaking

TAPPI Journal ◽  
2016 ◽  
Vol 15 (10) ◽  
pp. 631-639
Author(s):  
MOHAMMAD HADI ARYAIE MONFARED ◽  
HOSSEIN RESALATI ◽  
ALI GHASEMIAN ◽  
MARTIN A. HUBBE
Keyword(s):  
Adverse Effects ◽  
Control Sample ◽  
Pressure Sensitive Adhesive ◽  
Acrylic Fiber ◽  
Burst Strength ◽  
Pressure Sensitive Adhesives ◽  
Pressure Sensitive ◽  
Tear Index ◽  
Breaking Length ◽  
Acrylic Fibers

This study investigated the addition of acrylic fiber to old corrugated container (OCC) pulp as a possible means of overcoming adverse effects of water-based pressure sensitive adhesives during manufacture of paper or paperboard. Such adhesives can constitute a main source of stickies, which hurt the efficiency of the papermaking process and make tacky spots in the product. The highest amount of acrylic fiber added to recycled pulps generally resulted in a 77% reduction in accepted pulp microstickies. The addition of acrylic fibers also increased pulp freeness, tear index, burst strength, and breaking length, though there was a reduction in screen yield. Hence, in addition to controlling the adverse effects of stickies, the addition of acrylic fibers resulted in the improvement of the mechanical properties of paper compared with a control sample.

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