Development of a disposable spray canister for talc pleurodesis. A preliminary report

Our plain-English summary of Development of a disposable spray canister for talc pleurodesis. A preliminary report, by H.G. Colt, J.F. Dumon (Chest, 1994).

The study

• Authors: H.G. Colt, J.F. Dumon
• Journal: Chest
• Published: 1994;106(6):1776-80
• Cited by: 12 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Talc pleurodesis has been used for more than 50 years in both the United States and in Europe, and it has proven to be safe and effective in patients with malignant pleural effusions as well as recurrent pneumothorax. In this preliminary report, we describe a disposable, single-use spray canister that allows intrapleural administration of sterile, asbestos-free Luzenac talc, thus facilitating thoracoscopic talc insufflation for pleurodesis, particularly in patients with recurrent malignant effusions. The talc is delivered ready to use, administered via a hollow plastic delivery catheter that can be inserted through the pleural trocars used during thoracoscopy. Use of this spray canister allows practitioners to avoid complex handling and sterilization procedures required for bulk talc powder.

In plain English

In this preliminary report, the authors described a single-use, disposable spray canister for spraying sterile talc, described as asbestos-free, into the chest cavity (talc pleurodesis), mainly during thoracoscopy. Each canister held 4 g of Luzenac PR 7841 talc powder, with talc and chlorite at 95% or more. The authors reported using the device in 12 patients with malignant pleural effusions and 9 with spontaneous pneumothorax. Pleurodesis was judged successful at 90 days in 11 of the 12 effusion patients and in all pneumothorax patients, who were followed for 1 year. No complications of talc administration occurred, although about 30% of patients had low-grade temperatures after thoracoscopy. The authors concluded the canister was effective and practical. They noted that it was expensive compared with other talc preparations. They also noted that the amount of talc delivered could not be measured when less than a full canister was used, and that the catheter tips were sharp enough to tear lung. In discussing other researchers' work, not data from this report, the authors wrote that current evidence suggests fears of cancer from asbestos-free, pure talc are unfounded. They added that further research is required.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Preliminary report describing a medical device (a talc spray canister), with brief uncontrolled clinical experience in a small number of patients
• Who was studied: 21 patients: 12 with malignant pleural effusions and 9 with spontaneous pneumothorax, who also had bleb or bulla resection. The article does not state where or when they were treated.
• Exposure: Intrapleural spraying of up to 4 g of sterile Luzenac PR 7841 white talc powder (talc and chlorite concentration 95% or more), described as asbestos-free, delivered from a gamma-sterilized pressurized canister
• Main results:
  • Pleurodesis was successful at 90 days in 11 of 12 patients with malignant pleural effusions, and in all patients with pneumothorax (follow-up 1 year)
  • No complications of talc administration occurred in the treated patients
  • About 30% of the treated patients had low-grade temperatures after thoracoscopy
  • Not a finding of this report: in their discussion of other studies, the authors wrote that current evidence suggests fears of neoplasms caused by asbestos-free, pure talc are unfounded, while stating that further research is required
• The authors' conclusion: The authors concluded that the disposable canister is effective and practical
• Limitations the authors state:
  • The canister is expensive compared with other talc preparations
  • When less than the entire canister is used, there is no way to measure how much talc was delivered. The authors used the whole canister for some patients and only a few sprays for others.
  • The delivery catheter tips are too sharp and could tear lung tissue
  • Delivery under pressure is a potential danger, although no pressure-related damage had yet been seen
  • The authors found spraying talc through an indwelling chest tube unsatisfactory, because the talc clumps inside the tube

Topics

The National Library of Medicine indexes this study under subjects our site covers: Talc and vermiculite.

Medical terms in this study, explained in our Lexicon: Talc Pleurodesis, Pleural Effusion, Pneumothorax, Talc, Pleurodesis, Thoracoscopy.

Related studies

• A randomized controlled trial of the efficacy of cosmetic talc compared with iodopovidone for chemical pleurodesis — R. Agarwal, A.S. Paul, et al. (2011)
• Talc Pleurodesis: A Medical, Medicolegal, and Socioeconomic Review — I. Baiu, E. Yevudza, et al. (2020)
• Talc slurry pleurodesis. Pleural fluid and histologic analysis — L. Kennedy, R.A. Harley, et al. (1995)
• Medical thoracoscopic talc pleurodesis for chylothorax due to lymphoma: a case series — D.C. Mares, P.N. Mathur (1998)
• Survival in patients with malignant pleural effusion undergoing talc pleurodesis — M. Hassan, R.M. Mercer, et al. (2019)
• Sterilization of talc for pleurodesis. Available techniques, efficacy, and cost analysis — L. Kennedy, L.M. Vaughan, et al. (1995)

Browse more research in Chest, or return to medical research.