Utility and Efficiency of «The Gentle Injection of Fibrin Glue» in Neurosurgical Operative Field: Technical Note

Abstract

The first publication reporting the used fibrin sealant during intracranial tumor surgery for difficult hemostatic problems was in 1984. The neurosurgical operative field requires rigorous hemostasis, inopportune use of bipolar coagulation can be dangerous and lead to a post-operative ischemic complication. Otherwise, coagulation is sometimes not feasible because of the noble anatomical juxtaposed with the hemorrhagic focus. There is still a great deal of confusion concerning optimal use of bio surgical hemostatic agent, because of the wide range of products, performing their hemostatic action in different ways. Using Tisseel VH fibrin sealant glue as a biological adhesive glue indicated as an adjuvant local hemostatic in neurosurgical operative field was inspired by limitations related to other surgical techniques. We will expose in this technical note our team's experience of using a Tisseel glue. The goal of this technical note is to deliver to young neurosurgeon or to inexperimented team some tips and recommendations about fibrin glue and its efficiency in reducing neurosurgical morbidity. We report the utilisation of Tisseel in many cases of neurosurgery when conventional method failed. An additional literature search was performed in the PubMed, Embase, and Cochrane databases to compare our tips to published one. The film glue is deposited as a "wrap" "around a suture, it can be used as an adjuvant for dissection intracranial parenchyma, it can be most efficient than surgical wax for some bone bleeding around emissary veins.