TachoSil® in the treatment of postoperative groin lymphatic fistula.

Dear Editor, Vascular reconstruction unavoidably results in lymphatic injury due to the intricate association of lymphatics with arteries and veins. There are also signifi cant lymph node groups found near the major vessels. The lymphatic system, however, has a remarkable ability to regenerate and most injuries to the lymphatics heal spontaneously without lasting effects. In some cases, however, lymph swelling, lymph fi stulas and lymphocoele can occur. Although lymphatic complications are relatively uncommon, longterm lymphatic leaks incur the risk of infection which can be dangerous especially in patients with vascular prosthesis in the groin.1 Further, there are no standard procedures for detecting and treating lymph fi stulas. Existing treatments are conservative approaches and surgical intervention.1,2 Recommendations for initial conservative approach have signifi cant disadvantages: extended hospital stay and increased risk of wound and graft infection. Some authors therefore recommend early surgical intervention.3,4 Here we present a modifi ed conservative approach involving TachoSil® placement in groin wound with a lymphatic leak. TachoSil® [Nycomed Austria GmbH] is used as a topical haemostatic treatment for bleeding from parenchymatous organs and non-surgical treatment for bleeding from vascular anastomoses in surgery.