Bone wax is a waxy substance used to help control bleeding mechanically from the bone surface during surgical procedures.
These are generally made of beeswax with softening agents such as paraffin or petroleum jelly and applied on the bleeding edge of the bone, blocking the hole and causing bone hemostasis immediately through the tamponade effect. Bone wax is most often supplied with sterile sticks, and usually requires softening before it can be used.
Video Bone wax
Histori
A note by Victor Horsley published in the British Medical Journal in 1892 describes an "antiseptic wax formulation" that has seven parts of beeswax, one part almond oil, and 1% salicylic acid. The material is useful for controlling bleeding when pressed into the pores and channels cutting or damaging the bone. The wax is sterilized by boiling and stored in a closed bottle. This material soon becomes the standard of care for bone-bone control for general orthopedics, craniomaxilofacial surgery, and cardiothoracic surgery, in which the sternum is often split longitudinally to provide access to the heart.
Maps Bone wax
Action
Ordinary bone wax is effective due to tamponade action, but is considered to have no active hemostatic properties (ie not activating a blood coagulation cascade). In addition, wax bones do not dissolve in body fluids and thus remain in the implantation site for long periods of time, if not indefinitely. The traditional portion of bone wax leaving the implant site is most likely carried by the action of a foreign body response and is associated with a low-level inflammatory response at and near the implant site. The residue product also has the potential to function as a nidus for postoperative infections.
Modern formulation
Modern bone wax is currently commercially available in formulations that are substantially unabsorbable similar to Horsley's original compositions, as well as in an absorbable/resorbable format. Most of them are available as strong waxes in the form of sticks that should be softened with pengulenan before use.
More recent advances have led to the introduction of bone hemostat in a putty format. Hemostatic putties act through the tamponade in the same way as wax sticks, but are ready to use and eliminate the requirement to soften the product before use.
Brand name
Bone wax absorbs
Hemasorb Resorbable Hemostatic Bone Putty is a sterile, soft, formable, biocompatible material, can be absorbed with consistency such as putty. The ingredients are a mixture of calcium stearate, vitamin E acetate, and liquid surfactant. It's virtually odorless, faded white and can spread easily with minimal adhesion to surgical gloves. Bone putty does not require pressing before application and does not soften at body temperature.
The FDA recently approved a new water-soluble bone hemostasis material called Ostene, which is designed to look and feel like bone wax. This material comprises a sterile mixture of water-soluble alkylene oxide copolymers derived from ethylene oxide and propylene oxide. These copolymers have a long history in the medical and pharmaceutical fields, and they are considered inert. This compound is not metabolized, but is removed from the body unchanged.
References
- Horsley, V. Antiseptic wax. Brit. M. J. 1165, 1892
- Summary of Hemasorb 510 (k)
- Summary of Ostene 510 (k)
Source of the article : Wikipedia
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