Prevention of prolonged air leak in lung resection surgery; a novel application of a haemostatic agent.

<bold>Introduction:</bold> Lung resection surgery is a common lifesaving procedure; however, there are associated risks. Prolonged air leak due to an alveolar-pleural fistual is the most common complication after lung surgery, which has an increased risk of morbidity and mortality, longer chest drain duration and ultimately prolonged hospitalisation₍₁₎. Very few agents are effective against air leaks. Purabond is a licenced haemostatic agent where a matrix is formed from synthetic peptides, composed of three naturally occurring amino acids. The peptides self-assemble to form a 3-dimensional matrix upon a change in pH2 caussed by exposure to an ionic solution such bodily secretions. It is hypothesised, that Purabond fills the gap in lung parenchyma, thus reducing air leak. <bold>Method</bold> Data was collected prospectively from October 2023 to February 2024 from a single institution. Purabond (5mls) was applied at the end of lung resection procedures at the staple line prior to re-inflation of the lung. Patient outcomes were collected up to discharge and at the two week post operative review. <bold>Results:</bold> Twenty-Two patients (N=22) were included. Indications for surgery included primary and metastatic cancer and bullous lung disease. The mean FEV1 was 2.14L and mean DLCO was 58%.4.8% (n=1) developed prolonged air leak. Mean duration of chest drain requirment was 2.1 days and duration of hospital stay was 3.7 days. There was no post operative complications documented. <bold>Conclusion:</bold> Purabond in lung resection surgery is safe and feasible in potentially reducing post operative air leak. The use of Purabond has the potential to reduce chest drain requirment and hospital stay. This study demonstrates the need for an RTC to test this hypothesis.