Oxidized regenerated cellulose particles enable high-pressure air-leak sealing on lung segmentectomy surfaces in porcine models

Objective: Pulmonary air leakage is a common complication that hinders rapid recovery after lung segmentectomy. Oxidized regenerated cellulose flat (ORCF) combined with fibrin glue (FG) has shown efficacy in preventing air leaks in previous studies but is limited by inadequate tissue coverage. This study aimed to evaluate commercially available oxidized regenerated cellulose particles (ORCP; SURGICEL Powder) using a porcine model of lung segmentectomy to address the limitations of conventional ORCF. Methods: A porcine lung segmentectomy model was established, and experimental animals were randomly assigned to six groups: blank control, FG alone, ORCF-FG, polyglycolic acid (PGA) sheet-FG, ORCP-FG, and ORCP-FG-ORCF. The sealing efficacy of different treatments was evaluated by measuring the minimum air leakage pressure (MALP). Histological characteristics of the sealed resection surfaces were further analyzed, including quantitative assessment of interfacial gap ratio and sealing-layer thickness. Results: O), which was significantly higher than that of all other groups (p < 0.001). The ORCP-FG and PGA-FG groups exhibited comparable MALP values, both significantly higher than that of the ORCF-FG group. Histological analysis demonstrated improved sealing-layer integration and adherence in the ORCP-FG and PGA-FG groups relative to the ORCF-FG group. Quantitative histological analysis further revealed that the PGA-FG group had the lowest interfacial gap ratio, while sealing-layer thickness did not parallel mechanical sealing performance across groups. Conclusion: ORCP-FG exhibits strong sealing performance in this porcine ex vivo model, with efficacy comparable to the current clinical benchmark of PGA-FG. As an improved biodegradable sealing material, ORCP overcomes the insufficient tissue coverage of conventional flat ORCF, serving as a mechanically effective alternative for preventing postoperative pulmonary air leakage after lung segmentectomy and providing a promising new clinical strategy.