TachoSil® (Nycomed) is the first Fibrin Sealant Sponge registered in Australia. It is a biodegradable sponge of equine collagen with a dry coating of fibrinogen and thrombin derived from human plasma.
Experienced surgeons may apply the moistened sterile sponge to cover wounds where standard surgical techniques to control bleeding are ineffective or impractical. Physiological fluids dissolve and diffuse the fibrin and thrombin into the wound surface, initially forming a fibrin clot to adhere the sponge to the wound surface, and subsequently creating a firm, stable seal.
TachoSil should not be used in patients who may be sensitive to the protein components or in procedures involving the renal pelvis or ureter because it may be a focus for calculus formation. Intravascular application may result in life-threatening thromboembolism.
The risk of transmitting infective agents, including unknown or emerging pathogens, in products derived from human blood and plasma can not be eliminated. Symptoms of fever, drowsiness, chills and runny nose followed about two weeks later by a rash and joint pain may indicate infection with parovirus B19 which is serious for pregnant and immunocompromised patients and those with haemolytic anaemia. TachoSil may also potentiate an existing infection if used in a contaminated space.
TachoSil can be denatured by exposure to solutions containing alcohol, iodine or heavy metals (e.g. antiseptic solutions) and these should be removed as much as possible before application. Adverse effects are generally mild, the most frequent being atrial fibrillation. pyrexia, and pleural effusion.