Complications secondary to the use of standard bone wax in seven patients

Ordinary bone wax, manufactured from beeswax, was used to stop bleeding from cancellous bone in elective surgery among seven women. Five of them had a resection of a calcaneal exostosis and bursa at the insertion of the calcaneous tendon, one underwent a resection of a medial exostosis of the first metatarsal head, and one had an acromial resection. Postoperatively, all patients had disabling local pain and tenderness. Three of them developed firm visible swellings where bone wax had been used, which was easily palpable under the intact skin. At reoperation, 4 to 52 months later, masses of brown, soft granulation tissue were excised in all patients. Five of seven were relieved from pain. Microscopically, a bone wax granuloma with marked foreign body reaction was seen in all patients.