Does bone wax make sense in off-pump coronary surgery? A prospective randomized study

Area of Science:

• Cardiovascular Surgery
• Surgical Hemostasis
• Wound Infection

Background:

• The impact of bone wax on sternal infection and bleeding during off-pump coronary artery surgery is not well-documented.
• High-risk patients undergoing off-pump coronary artery surgery may benefit from interventions that minimize complications.

Purpose of the Study:

• To prospectively evaluate the effect of bone wax on sternal infection and intraoperative bleeding in patients undergoing off-pump coronary artery surgery.
• To assess the potential impact of bone wax on cell saver utilization in this patient cohort.

Main Methods:

• A prospective randomized study involving 58 diabetic patients with two-vessel coronary artery disease undergoing off-pump surgery.
• Patients were randomly assigned to either a bone wax group or a no-wax control group.

Main Results:

• No significant difference in intraoperative blood loss was observed between the bone wax (550 ml) and no-wax (750 ml) groups (p = 0.0711).
• Absence of bone wax (OR=3.9, p=0.027) and higher preoperative creatinine levels were independent predictors of significant blood loss (≥750 ml).
• Red blood cell transfusion units and wound healing complications were similar between groups.

Conclusions:

• Bone wax use does not elevate the risk of sternal wound infection in off-pump coronary artery surgery.
• Bone wax may potentially reduce intraoperative blood loss, possibly decreasing cell saver use, though this effect requires further investigation.