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Experiences with TachoSil® in microneurosurgery.

AbstractBACKGROUND:
We analyze our experience of using TachoSil® (Takeda Austria GmbH: Linz, Austria) in microneurosurgical procedures as a hemostat and also as a sealant to patch dural defects.
MATERIALS AND METHODS:
Beginning on January 1, 2012, we prospectively analyzed 100 consecutive surgeries where TachoSil was used. The patient group included 58 women (58 %) and 42 men (42 %); the mean age was 52 years (range, 3-85 years). Indications for surgery included removal of the tumor (53 cases; 53 %), clipping of the cerebral arterial aneurysm (31 cases; 31 %), and treatment of other pathologies, including AVM (four cases; 4 %), cavernomas (four cases; 4 %), spinal tumor, and traumatic subdural hematoma. Patients received postoperative care according to local neurosurgical department protocol, including a postoperative CT scan after each craniotomy. Primary assessment of the wound took place during the hospital stay as well as at discharge or transfer to a rehabilitation unit. Mean follow-up time was 4 months (range, 1-12 months).
RESULTS:
None of the patients developed postoperative hematoma after craniotomy or spinal procedure. At primary assessment during hospital stay, 93 patients (93 %) had had no wound-related problems over the normal course of healing. No case registered any liquor leak from the wound, and none of the patients showed any signs of allergic response related to TachoSil usage. At the last follow-up, 96 patients (96 %) experienced uneventful wound healing, and in four patients (4 %), superficial wound infection was successfully treated with oral antibiotics.
CONCLUSIONS:
Our results indicate that TachoSil can serve in neurosurgical practice at no additional risks. TachoSil proved to be an effective hemostat, sealant, and adhesive in either cranial or spinal procedures.
AuthorsJuri Kivelev, Felix Göhre, Mika Niemelä, Juha Hernesniemi
JournalActa neurochirurgica (Acta Neurochir (Wien)) Vol. 157 Issue 8 Pg. 1353-7; discussion 1357 (Sep 2015) ISSN: 0942-0940 [Electronic] Austria
PMID26136196 (Publication Type: Evaluation Study, Journal Article)
Chemical References
  • Drug Combinations
  • Fibrin Tissue Adhesive
  • TachoSil
  • Fibrinogen
  • Thrombin
Topics
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Neoplasms (surgery)
  • Cerebral Revascularization (methods)
  • Cerebrospinal Fluid Leak (epidemiology)
  • Child
  • Child, Preschool
  • Craniotomy
  • Drug Combinations
  • Female
  • Fibrin Tissue Adhesive (adverse effects, therapeutic use)
  • Fibrinogen (adverse effects, therapeutic use)
  • Follow-Up Studies
  • Hemostasis, Surgical (methods)
  • Humans
  • Incidence
  • Intracranial Aneurysm (surgery)
  • Length of Stay
  • Male
  • Microsurgery (methods)
  • Middle Aged
  • Operative Time
  • Postoperative Complications (epidemiology)
  • Prospective Studies
  • Retrospective Studies
  • Thrombin (adverse effects, therapeutic use)
  • Treatment Outcome
  • Young Adult

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