A comparative study to evaluate the efficacy of sealants alone and in combination with collagen sheet in a pig isolated lung air leak model

Objective. This study aimed to evaluate the efficacy of three sealants (acrylate latex, fibrin-thrombin complex and cyanoacrylate derivative) alone or combined with collagen patches in sealing pulmonary air leaks using an ex vivo porcine lung model. Material and methods. Fresh porcine lungs (n=18) were standardized, and penetrating defects (2×2 cm) were created to simulate clinical air leakage. Lungs were connected to a mechanical ventilation system (PEEP=5 cm H2O, I:E=1:2). Samples were randomized into six groups (n=3/group) to test sealants alone or combined with 3×3 cm collagen patches. Air leakage frequency, patch stability, and maximum tolerated pressure were assessed by incrementally increasing ventilation pressures (20—50 cm H2O). Results. The cyanoacrylate glue + collagen patch group demonstrated 100% sealing integrity at the maximum ventilator pressure (50 cm H2O) without interface delamination, significantly outperforming other groups. In contrast, fibrin-thrombin glue + patch and latex glue + patch groups exhibited air leakage and patch detachment at 40 cm H2O and 25 cm H2O, respectively. Conclusion. This ex vivo model effectively screened material combinations. Cyanoacrylate glue combined with collagen patches exhibited superior high-pressure sealing performance in the ex vivo setting. However, long-term efficacy and biocompatibility require further study.