The effect of sodium hyaluronate-carboxymethyl cellulose membrane in the prevention of parenchymal air leaks: an experimental and manometric study in rats.

Introduction: We aimed to examine effectiveness of sodium hyaluronate-carboxymethly cellulose (NaH/CMC) for sealing pulmonary air leaks during postoperative period.

Materials And Methods: The study was conducted in 16 male Sprague-Dawley rats. A linear insicion (length= 0.2 cm, depth= 0.1 cm) to the lung parenchyma on the inflated by a cutter was made. The animals were randomly divided; the control group (n= 8) and NaH/CMC-treated group (the study group, n= 8). Control group was left for physiologic healing while a NaH/CMC membrane was applied over the the incisional area in the study group. Then the pressure point where the air leakage observed was noted.

Result: No polymorphonucleer leucocytes (PMNL) infiltration was detected in control group, whereas PMNL infiltration was 0.38 ± 0.5 cell per 100 high field in study group (p= 0.234). The degree of macrophage, lymphocyte infiltration and the mean fibroblast count were found to be higher in study group compared with control group (p= 0.007, p= 0.02, p= 0.05, respectively). The mean pressure value for air leak to occur in the control group was 43.50 ± 9.55 mmHg whereas it was 73.75 ± 16.68 mmHg in the study group (p< 0.001).

Conclusions: The data revealed that bioabsorbable NaH/CMC membrane accelerates healing with preserving the expansile character of lung parenchyma even in high ventilation pressures. However, further studies are required to assess the prevent impact of the pulmonary air-leak for NaH/CMC membrane.