ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Bone wax use in open heart surgery: Is it safe?
Mustafa Bahadır İnan, Deniz Bozdoğan, Mustafa Şırlak, Levent Yazıcıoğlu, Burak Açıkgöz, Rüçhan Akar, Sadık Eryılmaz, Ümit Özyurda
Ankara Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Ankara, Türkiye
DOI : 10.5606/tgkdc.dergisi.2012.100
Background: In this study, we aimed to investigate the effects of bone wax use on mortality and morbidity.

Methods: Our retrospective study included 191 patients (118 males, 73 females; mean age 50.1±2.9 years; range 22 to 81 years) who underwent cardiac surgery via median sternotomy and cardiopulmonary bypass (CPB) between January 2008 and May 2009 in our clinic. The patients were divided into two groups comprised of those who were administered bone wax, and those who were not. The groups were compared for blood product requirement, incidence of resternotomy, sternum stabilization, superficial wound infection, mediastinitis, and early mortality.

Results: The demographic and operative data of the patients in both groups were similar. Coronary artery bypass grafting (CABG) was the most commonly performed surgery, followed by mitral and aortic valve surgery and the Bentall procedure. The incidence of surgical mortality was one patient per group. The mean amount of bleeding at 12 and 24 hours after surgery were 484.9±112.0 mL and 523.3±174.4 mL in the first group and 504.7±134.4 mL and 577.6±181.1 mL in the second group, respectively. Although the amount of bleeding in the bone wax group at 12 and 24 hours following surgery was lower, the difference between the groups was not statistically significant (p=0.457 at 12 hours; p=0.388 at 24 hours). A total of five patients were re-explored two in the first group and three in the second group. There was no statistical difference between the groups in terms of the blood products used. Six patients experienced an infection of the sternotomy skin incision, and four of them fully recovered with antibiotic treatment. Sternal revision and the pectoralis major muscle flap procedure were performed on two patients, one in each group, due to resistant infection and sternal instability.

Conclusion: There was no significant decrease in the postoperative bleeding and blood product requirement following the use of bone wax. In addition, it did not increase the incidence of surgical infection.

Keywords : Bleeding; cardiac surgery; coronary artery bypass grafting
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