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Is bonewax safe and does it help?

Jörg Prziborowski¹, Martin Hartrumpf, Ulrich A Stock

¹Department of Cardiovascular Surgery, Heart Center Brandenburg, Bernau bei Berlin, Germany.

The Annals of Thoracic Surgery

|February 23, 2008

Summary

This summary is machine-generated.

Bonewax application after sternotomy is safe for coronary bypass patients, showing no increased risk of complications. However, it did not demonstrate significant benefits like reduced blood product use.

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Area of Science:

Cardiovascular Surgery
Surgical Materials Science

Background:

Bonewax is commonly used to seal sternal edges after median sternotomy.
Concerns exist regarding its potential adverse effects on sternal healing, but evidence is limited.

Purpose of the Study:

To evaluate the safety and efficacy of bonewax in coronary bypass surgery.
To determine if bonewax influences sternal healing, rethoracotomy rates, wound complications, or mediastinitis.

Main Methods:

A prospectively randomized study compared 400 coronary bypass patients, with 200 receiving bonewax and 200 not.
Outcomes assessed included blood product consumption, early rethoracotomy, sternum stabilization, mediastinitis, and early mortality.
Logistic regression analyzed risk factors like age, sex, diabetes, and bonewax use.

Main Results:

No significant differences were observed in early rethoracotomy (6.5% vs. 5%), sternal stabilization (3% vs. 3%), or mediastinitis (1% vs. 0.5%) between groups.
Blood product consumption was nearly identical between the bonewax and non-bonewax groups.
Bonewax was not identified as an independent risk factor for adverse outcomes, though early mortality was higher in the bonewax group (2.5% vs. 0.5%).

Conclusions:

Bonewax application after median sternotomy does not appear to negatively impact postoperative complications or patient outcomes in coronary bypass surgery.
The study did not find significant benefits, such as reduced blood product usage, associated with bonewax.
Bonewax is deemed safe for sternal edge sealing but offers no particular advantage.