Beyond Hemostasis: Understanding the Risks of Bone Wax in Orthopedic Surgery - A Case Report

Osseous hemorrhage following a surgical incision or traumatic fracture can be a challenging issue to manage. During orthopedic surgeries, bone wax is frequently utilized as a surgical technique to enhance hemostasis and reduce bleeding from bone. The hemostatic effect of bone wax mostly stems from its physical characteristics. The advantages of using bone wax are that it is easy to handle, low cost, inert, malleable, and has good sealing capacity and bone adherence. A review of the literature also shows that the most notable side effects of using bone wax are allergic foreign body reactions, development of granulomas, infection, and disruption of bone healing.

We present two cases of exostosis where the main surgical procedure for exostosis excision involved the use of bone wax to achieve hemostasis. A few months later, they presented with delayed migration and discharge of bone wax from the site of the surgery. To remove the bone wax off the primary application site, both of these individuals needed surgical intervention.

When needed, bone wax should only be applied for the duration required to bring about hemostasis. It acts as a foreign body; hence, using bone wax may result in foreign-body granulomas. Bone wax is a cost-effective, user-friendly, and promptly efficient hemostatic substance; nevertheless, its advantages should not be blindly used without prior assessment of the associated hazards. In conclusion, even though bone wax is frequently used in Orthopedic surgeries to help with hemostasis and control bleeding, medical personnel must be aware of any possible risks involved with using it. It is essential to closely follow individuals who have received bone wax treatment to address any issues or problems that may develop.