Why you should read this article:

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To increase your awareness of craniopagus, a rare condition in which identical twins are joined at the head

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To identify the multidisciplinary skills and expertise required for successful separation of craniopagus twins

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To explore the pivotal role of nurses in the management and care of craniopagus twins in hospital

Craniopagus is a rare condition in which the skulls of conjoined twins, and the neurovascular structures in their skulls, are incompletely separated. Separation surgery is complex and requires a range of skills and expertise, including from all the nursing teams involved. A multidisciplinary group of professionals in a tertiary paediatric care setting in Italy developed a comprehensive protocol for the nursing care of craniopagus twins in hospital, informed by the findings of a literature review and the expertise of its members. The protocol was applied to the management of a pair of craniopagus twins who successfully underwent separation surgery at the authors’ hospital. The protocol describes the crucial role of nurses in the care of craniopagus twins and their families before, during and after separation surgery.