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Updated: Jul 1, 2026
Use of Human Perivascular Stem Cells for Bone Regeneration
Published on: May 25, 2012
Hemostatic efficacy of a novel Ca/P/S-based bone graft material and its preliminary clinical evidence in sternum
Jun-Neng Roan1, Pao-Yen Lin1, Jiin-Huey Chern Lin2,3,4
1Division of Cardiovascular Surgery, Department of Surgery, National Cheng-Kung University Hospital, College of Medicine, National Cheng-Kung University, Tainan, Taiwan.
Insights
A new synthetic bone graft substitute, Ezechbone® Granule CBS-400, effectively controlled bleeding and promoted sternal healing in cardiac surgery patients. This biomaterial shows promise for improving surgical outcomes and bone regeneration.
Area of Science:
- Biomaterials Science
- Surgical Innovation
- Orthopedic Research
Background:
- Median sternotomy, standard in cardiac surgery, often causes significant marrow bleeding and delayed healing, especially in vulnerable patients.
- Existing hemostatic agents can control bleeding but may hinder bone regeneration, creating a need for advanced solutions.
- Ezechbone® Granule CBS-400 is a novel synthetic calcium/phosphorus/sulfur-based bone graft substitute designed to address these challenges.
Purpose of the Study:
- To evaluate the hemostatic and osteoregenerative properties of Ezechbone® Granule CBS-400.
- To compare CBS-400 with conventional calcium-based hemostatic products.
- To assess the clinical efficacy of CBS-400 in high-risk cardiac surgery patients undergoing sternotomy.
Main Methods:
- In vitro blood clotting assays to determine clotting index.
- In vivo rat tibial implantation studies to assess clot stability and biocompatibility.
- Clinical pilot study in sternotomy patients measuring chest tube drainage, duration, and sternal healing.
Main Results:
- CBS-400 demonstrated rapid clot formation with the lowest blood clotting index in vitro.
- In vivo studies showed superior clot stability and reduced inflammation compared to controls.
- Clinical use resulted in reduced chest tube drainage, shorter drainage duration, and decreased ICU stays, alongside stable sternal healing.
Conclusions:
- Ezechbone® Granule CBS-400 exhibits combined hemostatic and osteoregenerative capabilities.
- This multifunctional biomaterial shows potential for improving outcomes in complex surgical settings like sternotomy.
- Further randomized clinical trials are recommended to validate findings and establish optimal usage protocols.
Abstract:
Median sternotomy is the standard approach for cardiac surgery. Still, it is often complicated by excessive marrow bleeding and impaired healing, particularly in frail patients, and conventional hemostatic agents can control bleeding but frequently compromise bone regeneration. We evaluated Ezechbone® Granule CBS-400, a fully synthetic Ca/P/S-based bone graft substitute, against commercially available calcium-based products to address this challenge. In vitro blood clotting assays showed that CBS-400 consistently achieved the lowest blood clotting index, indicating rapid clot formation. In vivo rat tibial implantation revealed denser and more stable fibrin fiber networks and markedly reduced white blood cell infiltration, highlighting superior clot stability and early biocompatibility compared with controls. Clinical pilot applications in high-risk sternotomy patients confirmed its translational relevance: CBS-400 reduced chest tube drainage, shortened drainage duration, and decreased intensive care unit stays while supporting stable sternal healing. These findings demonstrate that CBS-400 combines hemostatic efficacy with osteoregenerative potential, positioning it as a multifunctional biomaterial that may improve outcomes in complex surgical settings. Larger randomized studies are warranted to validate these results and define optimal clinical use.
