Evaluation of feasibility of hydroxyapatite putty as a local hemostatic agent for bone

Although bone wax is known to cause an inflammatory reaction in soft tissue and a delay of bone healing, it is usually the first choice to arrest bleeding from bone. Hydroxyapatite (HAP) putty is proposed here. This study evaluated the feasibility of HAP putty with respect to whether or not it has potential value as a hemostatic agent for bone. First, the adhesive strength of HAP putty to bone was evaluated. The adhesive strength of HAP putty to wet bone was much higher when compared with that of bone wax, even though the adhesive strengths of HAP putty and bone wax to dry bone were equivalent. Next, to evaluate the hemostatic ability of HAP putty, bony defects were made in rabbits. HAP putty could arrest bleeding from bone within 3 min. However, when the hemostasis was performed with bone wax, bleeding was arrested within 8 min. Thus, HAP putty showed better hemostatic ability than bone wax. Finally, the tissue response to HAP putty in rabbit subcutaneous tissue was evaluated. Histological observation revealed a slight inflammatory response around HAP putty, whereas bone wax was surrounded by moderate inflammatory tissue. In conclusion, HAP putty has good potential value to be a hemostatic agent for bone because it has strong adhesion, good hemostatic ability, and biocompatibility.