Infection Rates and Healing Using Bone Wax and a Soluble Polymer Material

Division of Plastic and Reconstructive Surgery, the Department of Neurosurgery, University of Southern California, 536 S Rimpau Blvd, Los Angeles, CA 90020, USA.
Clinical Orthopaedics and Related Research (Impact Factor: 2.77). 03/2008; 466(2):481-6. DOI: 10.1007/s11999-007-0067-5
Source: PubMed


The effects of using a newly available water-soluble polymer bone hemostatic material in a contaminated environment were assessed in a rabbit tibial defect model. Infection rates and healing of polymer-treated bone were compared with the infection and healing of bone wax-treated bone and untreated controls after a bacterial challenge. Defects created in 24 rabbit tibias were treated with the polymer or bone wax, or left without a hemostatic agent. The defects were inoculated with Staphylococcus aureus ATCC-29213 (2.5 x 10(4) colony-forming units). After 4 weeks, all defects treated with bone wax were infected and osteomyelitis had developed, and none had evidence of bone healing. In the polymer and control groups, two defects in each group (25%) had osteomyelitis develop. The remaining six defects in each group (75%) showed no osteomyelitis and exhibited normal bone healing. The polymer-treated defects had a considerably lower rate of osteomyelitis and positive bone cultures compared with the bone wax-treated group. There were no differences between the polymer-treated and control groups in the rates of osteomyelitis, positive cultures, or bone healing. The use of a soluble polymer as an alternative to bone wax may decrease the rates of postoperative bone infections.

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    • "Since then bone wax has been used widely as a nonabsorbable hemostatic bone sealant. However, certain adverse reactions reported with its use include persistent granulomatous inflammation, foreign body reaction and promotion of infection, delayed bone healing and potential for neurological complications.414151617 "
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