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Particle size, distribution, and behavior of talc preparations

within the United States and beyond

Gilbert, Christopher R.a; Haouzi, Philippeb

Current Opinion in Pulmonary Medicine: July 2019 - Volume 25 - Issue 4 - p 374–379
doi: 10.1097/MCP.0000000000000573
DISEASES OF THE PLEURA: Edited by Richard Light

Purpose of review Talc remains a common sclerosant utilized for pleurodesis. However, the use of talc has documented complications and debate has persisted regarding the safety of talc as well as the differences in talc preparations available throughout the world. We sought to describe an up-to-date review of talc preparations available and the impact these preparations may have on the safety profile of talc.

Recent findings Within laboratory-based examinations, talc particle size available within the United States appears to be more consistent with prior reported ‘safe’ particle sizes. The presence of talc within protein-based solutions appears to modify the overall milieu of the solution and likely results in particle aggregation.

Summary The use of talc remains well accepted for pleurodesis as evidenced by inclusion by multiple guidelines. The medical fields’ current understanding of talc and its basic interactions within the pleural space remain limited. Multiple questions related to the pleural space and pleurodesis remain unanswered.

aDivision of Thoracic Surgery and Interventional Pulmonology, Swedish Cancer Institute, Seattle, Washington

bDepartment of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Penn State College of Medicine-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA

Correspondence to Christopher R. Gilbert, DO, MS, Division of Thoracic Surgery and Interventional Pulmonology, Swedish Cancer Institute, 1101 Madison St., Suite 900, Seattle, WA 98104, USA. Tel: +1 206 215 6800; fax: +1 206 215 6801; e-mail:

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