7．被覆（補強）材料

Current Status and Future Prospects of Covering, Reinforcement, and Sealant Materials in Thoracic Surgery

胸部外科領域における被覆（補強）材料には，さまざまな素材・形状のものが利用可能である．目的も多様で，切除された組織欠損部を被覆し周囲臓器の偏位を抑制する目的，外力から胸腔内臓器を保護する目的，臓器の縫合部や剝離面・切離面といった外科処置が施行された創傷部からの血液・リンパ液・空気の漏出を封止・防止する目的などがある．被覆材の感染・癒着・変形，血液漏出による血腫，リンパ液漏出による乳び胸，空気の漏出による気胸・膿胸など，被覆（補強）材料に伴う術後合併症がいまだに一定割合発生している現状は，その機能がわれわれ胸部外科医のニーズを完全には満たしていないことを意味している．

Various types of covering materials, reinforcement materials, and sealants with different compositions and structures are available in the field of thoracic surgery. However, complications such as infection, adhesion, and deformation of the materials, as well as hematoma caused by bleeding, chylothorax from lymphatic leakage, and pneumothorax or empyema due to air leaks, still occur at a certain rate. These issues indicate that the functions of currently available materials do not yet fully meet the needs of thoracic surgeons. In this article, we provide an overview of the classification, characteristics, and limitations of materials currently approved for use in Japan. Furthermore, we introduce recent advances in the development of novel materials—particularly surgical sealants—including an Alaska pollock gelatin sealant that we are co-developing for clinical application. In the development of new materials, improvements in physical properties, along with the availability of different formulations—such as liquid and sheet types—are expected to broaden their clinical applicability. The properties and limitations of each material are closely interrelated, and a thorough understanding of both is essential for optimal material selection and appropriate clinical use.