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Purpose <p>Pulmonary air leakage is a major concern in thoracic surgery, and polyglycolic acid (PGA) sheets are commonly used for pleural reinforcement. The fiber diameter and sheet flexibility may influence histocompatibility and pleural repair. This study compared a conventional 14-µm PGA sheet (14-PGA) with a thin-fiber 2-µm PGA (2-PGA) and flexible thin-fiber prototype (2-fPGA).</p> Methods <p>Standardized pleural defects were created in beagle dogs and then were repaired using fibrin glue. The primary endpoint was histological assessment on days 3, 7, 14, 28, and 56 (<i>n</i> = 12 per time point), evaluating remnants of PGA fibers, inflammatory reactions, neovascularization, and foreign body granulomas. The secondary endpoints were burst pressure testing (<i>n</i> = 5 per group) and surgeon-reported usability.</p> Results <p>The thin-fiber sheets demonstrated improved histocompatibility with earlier resolution of inflammation and foreign body reactions than 14-PGA. On Day 56, granuloma scores were higher in 14-PGA (mean 1.42, 95%CI 0.91–1.93) than in 2-PGA (0.08, − 0.08–0.25) and 2-fPGA (0.00, 0.00–0.00). The burst pressure was comparable among the groups. Surgeons have reported the superior conformability of 2-fPGA.</p> Conclusion <p>Altering the PGA sheet composition toward thin and flexible microfibers improved histocompatibility and facilitated pleural repair without compromising the sealing performance in this beagle model.</p>

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Alteration of PGA sheet composition improves histocompatibility and facilitates pleural repair

  • 期刊论文

  • 发表日期：

    2026年3月12日

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  • Kensuke Midorikawa,
  • Hiroyasu Nakashima,
  • Yuichiro Ueda,
  • So Miyahara,
  • Takeshi Shiraishi,
  • Toshihiko Sato

摘要

Purpose

Pulmonary air leakage is a major concern in thoracic surgery, and polyglycolic acid (PGA) sheets are commonly used for pleural reinforcement. The fiber diameter and sheet flexibility may influence histocompatibility and pleural repair. This study compared a conventional 14-µm PGA sheet (14-PGA) with a thin-fiber 2-µm PGA (2-PGA) and flexible thin-fiber prototype (2-fPGA).

Methods

Standardized pleural defects were created in beagle dogs and then were repaired using fibrin glue. The primary endpoint was histological assessment on days 3, 7, 14, 28, and 56 (n = 12 per time point), evaluating remnants of PGA fibers, inflammatory reactions, neovascularization, and foreign body granulomas. The secondary endpoints were burst pressure testing (n = 5 per group) and surgeon-reported usability.

Results

The thin-fiber sheets demonstrated improved histocompatibility with earlier resolution of inflammation and foreign body reactions than 14-PGA. On Day 56, granuloma scores were higher in 14-PGA (mean 1.42, 95%CI 0.91–1.93) than in 2-PGA (0.08, − 0.08–0.25) and 2-fPGA (0.00, 0.00–0.00). The burst pressure was comparable among the groups. Surgeons have reported the superior conformability of 2-fPGA.

Conclusion

Altering the PGA sheet composition toward thin and flexible microfibers improved histocompatibility and facilitated pleural repair without compromising the sealing performance in this beagle model.