Calcium phosphate cements to control bleeding in osteoporotic sternums
Derek D Muehrcke1, Pam Barberi, Will M Shimp
1Department of Cardiac Surgery, Flagler Hospital, St. Augustine, Florida, USA. dmuehrcke@aol.com
Insights
Orthopedic calcium phosphate cement effectively controlled bleeding from fragile, osteoporotic sternums after open heart surgery. This innovative method ensured immediate hemostasis and promoted excellent sternal healing without complications.
Area of Science:
- Orthopedic surgery
- Cardiothoracic surgery
- Biomaterials
Background:
- Osteoporotic sternal defects pose a significant bleeding risk in patients undergoing open heart surgery.
- Managing bleeding from fragile sternums requires effective and safe interventions.
Purpose of the Study:
- To evaluate the efficacy of orthopedic calcium phosphate cement in controlling sternal bleeding in patients with severe osteoporosis.
- To assess the safety and healing outcomes of using calcium phosphate cement for sternal defects.
Main Methods:
- Calcium phosphate cement was applied to the sternal table in 11 patients with >35% sternal surface deficit and bleeding post-open heart surgery.
- The cement was packed into deficient sternal areas before surgical closure.
Main Results:
- Immediate cessation of sternal bleeding was achieved in all patients following cement application.
- No patients required re-exploration for bleeding, and no superficial or deep sternal wound infections occurred.
- Follow-up revealed well-healed, firm sternums, with CT scans confirming excellent healing in 7 patients.
Conclusions:
- Calcium phosphate cement is a safe and effective option for controlling bleeding in patients with osteoporotic sternums.
- This method facilitates successful sternal healing after complex cardiothoracic procedures.
Purpose:
A new method to control bleeding from fragile, severely osteoporotic sternums in patients undergoing open heart surgery.
Description:
From January 2006 and January 2007, we used orthopedic calcium phosphate cement in 11 patients to control sternal table bleeding. Each patient had greater than 35% of their sternal table surface missing and had associated bleeding after open heart surgery. The cement was packed into the deficient sternal table surface at the conclusion of surgery, just prior to closure.
Evaluation:
All patients had immediate cessation of bleeding from their sternums, despite large superficial sternal deficits, after the cement was applied. All patients made uneventful recoveries and none required exploration for bleeding after surgery. There were no instances of superficial or deep sternal wound infections. At follow-up all sternums were well healed and firm. Seven patients had computed tomographic scans performed at 6 months revealing excellent complete sternal healing.
Conclusions:
Calcium phosphate cement can be used safely to control bleeding in patients with osteoporotic sternums and seems to be safe to use in the sternum.
Related Concept Videos
01:40Bone Remodeling
01:31Osteoclasts in Bone Remodeling
01:17Hormones and Bone Tissue
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
01:31Essential Minerals for Bone Health
Calcium and Phosphorus
Calcium is a critical component of bones, especially in the form of calcium phosphate and calcium carbonate. Since the body cannot make calcium, it must be obtained from the diet. However, calcium cannot be absorbed from the small intestine without...
01:21Skeleton and Calcium Homeostasis