Efficacy and safety of human fibrinogen-thrombin patch (Tachosil ？ ) in the management of diffuse bleeding after chest wall and spinal surgical resection for aggressive thoracic neoplasms

In order to obtain a successful surgical outcome, a proper and effective haemostasis is crucial in all fields of surgery. Major bleeding is usually controlled by standard surgical techniques (e.g., coagulation, ligation of blood vessels, clips) whilst a diffuse bleeding represents a serious problem that usually cannot be managed in the same way. Among the new systems aiding the control of bleeding, fibrin sealants (FS) play an important role, which has been recognized in a vast range of surgical fields. FS are generally made by two major components, fibrinogen and thrombin. Through the fibrinogen activation by thrombin, FS mimic the coagulation cascade final process with the formation of a semi-rigid clot (1). The recognition of FS haemostatic action allowed their use across several fields of surgery including abdominal and hepatic, urologic, cardiovascular and thoracic ones (2)