The reconstructive role of TachoSil in neurosurgery

• Hemorrhages, cerebrospinal fluid (CSF) fistula and infections are challenging post-operative complications.
• TachoSil® is a fixed combination of a collagen matrix coated with two coagulation factors such as fibrinogen and thrombin.
• TachoSil demonstrated to be able to cover the ventricular wall defect, avoiding the risk of ventricular obstruction.
• We pointed out on its effect on the ventricular wall to avoid communication between ventricles and surgical field.

Hemorrhages, cerebrospinal fluid (CSF) fistula and infections are the most challenging post-operative complications in Neurosurgery [1–5]. Fibrin sealant agents have been developed with the aim to provide efficient hemostasis and safe dural closure [3,6–14]. In this study we report our initial experience using TachoSil® (haemostatic surgical patch; Nycomed, Linz, Austria) in achieving hemostasis and CSF leakage repair during cranio-cerebral procedures [15–18]. We describe and show the unique features of this fibrin sealant, pioneered with stunning success in many surgical procedures known to be at high risk of peri- and postoperative bleeding (i.e. nephrectomies, pulmonary lobectomies, ballistic injuries, arthroplasties, coronary bypass graftings), but still not widely exploited at its best in the field of Neurosurgery.