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Author Spotlight: Enhancing Coronary Artery Revascularization
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Does bone wax make sense in off-pump coronary surgery? A prospective randomized study.

Zdenek Sorm1, Martin Vobornik1, Martin Dergel1

  • 1Department of Cardiac Surgery, Charles University, Faculty of Medicine and University Hospital in Hradec Kralove, Czech Republic.

Kardiochirurgia I Torakochirurgia Polska = Polish Journal of Cardio-Thoracic Surgery
|August 11, 2023
PubMed
Summary

Bone wax did not increase sternal infection risk in off-pump coronary surgery. While it may reduce bleeding, its impact on cell saver use remains uncertain.

Keywords:
blood transfusioncoronary artery bypass graft surgeryoff-pump surgerysternumwound healing

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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.