Intraoperative Implementation of a Tissue Sealant on All Lung Surgery Patients: A Quality Improvement Project

摘要

More than 200,000 patients undergo pulmonary surgery annually. Air leaks after pulmonary surgery are a common complication and represent a substantial clinical problem. Air leaks can increase chest tube time, increase pain, reduce mobility, and increase hospital length of stay. The application of a synthetic surgical lung sealant (SLS) to lung surfaces during surgery in patients at risk for an air leak has been advocated to reduce these complications.The aim of the project was to reduce or eliminate air leaks, decrease chest tube time, and decrease length of stay by applying an FDA-approyed tissue sealant during all pulmonary surgeries. The population of focus were adult pulmonary surgery patients undergoing pulmonary surgery.Data were collected on 146 patients: 72 patients the year prior to the intervention and 74 the year after implementation of the intervention. The incidence of air leak was significantly lower; the number of comorbidities was statistically higher in the group following implementation. There were, however, no significant differences in chest tube duration and length of hospital stay. The use of lung sealant on all patients undergoing pulmonary surgery had a positive outcome without any adverse effects and is now standard of practice.