Polyethylene Glycol (PEG)-Based Wet-Adhesive Absorbable Bone Wax for Osseous Hemostasis and Repair

The non-absorbability and biological inertia of traditional bone wax often result in foreign body retention, inhibit bone healing, and increase the risk of infection. Herein, a novel absorbable bone wax was developed by mixing polyethylene glycol (PEG), tannic acid (TA), sodium carboxymethyl cellulose (CMC), and low-molecular-weight poly-L-lactic acid (PLLA) via one-pot method. Among them, PEG functions as the matrix, endowing it with plasticity and hydrophilicity, thereby facilitating its facile, close fit to the surface of bone defects. TA, with its profusion of phenolic hydroxyl groups, bestows the material with exceptional adhesion properties. The hydroxyl and carboxyl groups in the CMC molecular structure are capable of forming hydrogen bond networks with PEG and TA. Concurrently, hydrophobic PLLA reinforces the hydrogen bond network structure. Absorbable bone wax maintains excellent adhesion in water. The obtained wax shows an adhesion strength of 27.07 kPa and can maintain adhesion to pig bone for 6.0 h in an aqueous environment. In particular, after being soaked in water for 24 h, the bone wax only dissolves on the surface, while the core remains intact. The results of the porcine sternum implantation experiment showed that the hemostatic performance of this bone wax was comparable to that of non-absorbable bone wax. Furthermore, the absorbable bone wax was gradually absorbed, leading to better bone tissue healing. This absorbable formulation could eliminate the 5-15% infection rate associated with traditional bone wax.