Improved outcomes utilizing a novel pectin-based pleural sealant following acute lung injury

J Trauma Acute Care Surg. 2020 Nov;89(5):915-919. doi: 10.1097/TA.0000000000002754.


Background: Persistent air leaks after thoracic trauma are associated with significant morbidity. To evaluate a novel pectin sealant in a swine model of traumatic air leaks, we compared a pectin biopolymer with standard surgical and fibrin-based interventions.

Methods: A standardized lung injury was created in male Yorkshire swine. Interventions were randomized to stapled wedge resection (n = 5), topical fibrin glue (n = 5), fibrin patch (n = 5), and a pectin sealant (n = 6). Baseline, preintervention and postintervention tidal volumes (TV) were recorded. Early success was defined as the return to near-normal TV (>95% of baseline). Late success was defined as no detectable air leak in the chest tube after chest closure.

Results: There were no differences in injury severity between groups (mean TV loss, 62 ± 17 mL, p = 0.2). Early success was appreciated in 100% (n = 6) of the pectin interventions which was significantly better than the fibrin sealant (20%, n = 1), fibrin patch (20%, n = 1), and stapled groups (80%, n = 4, p = 0.01). The percent of return to baseline TV after sealant intervention was significantly increased in the pectin (98%) and staple arms (97%) compared with the fibrin sealant (91%) and fibrin patch arms (90%) (p = 0.02; p = 0.03). Late success was also improved with the pectin sealant: no air leak was detected in 83% of the pectin group compared with 40% in the stapled group (p = 0.008)-90% of the fibrin-based interventions resulted in continuous air leaks (p = 0.001).

Conclusion: Pectin-based bioadhesives effectively seal traumatic air leaks upon application in a porcine model. Further testing is warranted as they may provide a superior parenchymal-sparing treatment option for traumatic air leaks.

MeSH terms

  • Acute Lung Injury / therapy*
  • Animals
  • Disease Models, Animal
  • Fibrin Tissue Adhesive / administration & dosage
  • Humans
  • Lung Injury / therapy*
  • Male
  • Pectins / administration & dosage*
  • Pneumonectomy
  • Surgical Stapling
  • Sus scrofa
  • Tissue Adhesives / administration & dosage*


  • Fibrin Tissue Adhesive
  • Tissue Adhesives
  • Pectins