Effective Hemostasis in Severe Mesenteric Vein Laceration with Tachosil(®), using a Low- or Non-thrombogenic Patch to Prevent Tachosil(®)-induced Thrombosis

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
Einar DregelidRavi Rawal

Abstract

Fibrinogen- and thrombin-coated collagen fleece (FTCC) facilitates surgical hemostasis, and is of particular value during resection of parenchymatous organs. Since thrombosis may ensue if the preparation is unintentionally applied intravascularly, it has not been recommended for treating lacerations of large veins, and no previous reports describe its use in vein repair. Our observations in two patients suggest, however, that FTCC might be indicated for hemostasis in vein injury where vascular suture is difficult or not possible, provided a low- or non-thrombogenic patch is interposed to prevent FTCC-induced vein thrombosis. Our two patients had severe lacerations of the proximal superior mesenteric vein (SMV) not amenable to conventional vein repair. Rapid hemostasis was obtained without suturing using Tachosil(®), an FTCC preparation, covered with omentum. In the first patient hemostasis was obtained at the expense of vein thrombosis, apparently due to contact between the coagulant-containing side of Tachosil(®) and the inside of the vein wall. In our second patient we therefore put a small patch of parietal peritoneum on the section of the Tachosil(®) targeted to cover the vein tear to avoid direct contact between Tachosil(®...Continue Reading

References

Aug 1, 2002·Journal of Pediatric Surgery·Roman Th CarbonStefanie-Isabell Simon
Apr 14, 2004·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·T JosephV Bahal
Sep 27, 2006·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Sylvia Haas

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Citations

Feb 1, 2012·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·R Andersson
Apr 18, 2019·Angiologii︠a︡ i sosudistai︠a︡ khirurgii︠a︡ = Angiology and vascular surgery·R N KomarovD B Andreev

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