Haemostasis and Healing following Median Sternotomy

Brightmore, T. G. J.; Hayes, Peter; Humble, J. G.; Morgan, A. D.

doi:10.1007/978-3-662-05557-1_8

Cited by 17 publications

(20 citation statements)

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“…The adverse effects of bone wax have been well documented (3, 4, 8, 13, 19, 23, 29, 34, 36, 42) and are reviewed in detail elsewhere (31, 40). Several experimental bone hemostasis agents have been described in the literature, including oxidized cellulose/poly(ethylene glycol) (12), fibrin/collagen paste (33), gelatin paste (41), patient-derived fibrin sealant (21), polyorthoester (33, 35), and hydroxyapatite putty (25), but none of these are in widespread use.…”

Section: Discussionmentioning

confidence: 99%

“…The most common complications recognized as being associated with bone wax are inhibition of osteogenesis (2, 5, 8, 29, 30, 31, 40), infection (3, 12, 13, 19, 26, 31), foreign body response causing a giant cell reaction (“wax granuloma”), local inflammation, and pain (4, 11, 23, 29, 34, 36, 42). Other complications attributed to the use of bone wax include quadriplegia after spine surgery (10), lower extremity paralysis after thoracotomy (9), sigmoid sinus obstruction after mastoid surgery (15, 23), and cerebrospinal fluid leakage after cranial base surgery (7).…”

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confidence: 99%

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Ostene, a New Alkylene Oxide Copolymer Bone Hemostatic Material, Does Not Inhibit Bone Healing

Magyar

Aghaloo

Atti

et al. 2008

Operative Neurosurgery

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OBJECTIVE-In this study, we investigate the effects of a soft bone hemostatic wax comprised of water-soluble alkylene oxide copolymers (Ostene; Ceremed, Inc., Los Angeles, CA) on bone healing in a rat calvaria defect model. We compared the effects with a control (no hemostatic agent) and bone wax, an insoluble and nonresorbable material commonly used for bone hemostasis.METHODS-Two bilateral 3-mm circular noncritical-sized defects were made in the calvariae of 30 rats. Alkylene oxide copolymer or bone wax was applied or no hemostatic material was used (control). After 3, 6, and 12 weeks, rats were sacrificed and the calvariae excised. Bone healing, expressed as fractional bone volume (± standard error of the mean), was measured by microcomputed tomography.RESULTS-Immediate hemostasis was achieved equally with bone wax and alkylene oxide copolymer. Bone wax-filled defects remained unchanged at all time points with negligible healing observed. At 3 weeks, no evidence of alkylene oxide copolymer was observed at the application site, with fractional bone volume significantly greater than bone wax-treated defects (0.20 ± 0.03 versus 0.02 ± 0.01; P = 0.0003). At 6 and 12-weeks, alkylene oxide copolymer-treated defects continued to show significantly greater healing versus bone wax (0.18 ± 0.04 versus 0.05 ± 0.01 and 0.31 ± 0.04 versus 0.06 ± 0.02, respectively). At all time points, alkylene oxide copolymer-treated and control defects showed good healing with no significant difference.CONCLUSION-Alkylene oxide copolymer is an effective hemostatic agent that does not inhibit osteogenesis or bone healing.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Ostene, a New Alkylene Oxide Copolymer Bone Hemostatic Material, Does Not Inhibit Bone Healing

Magyar

Aghaloo

Atti

et al. 2008

Operative Neurosurgery

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“…17 It liquefies between 62 C and 64 C. Its density at 15 C is 0.958-0.970 g/cm 3 . After it becomes a solid, the bone wax causes (generates) a very important inflammatory reaction with constitution of a tissue fibrosis with macrophage and lymphocyte infiltration.…”

Section: Embolization Materialsmentioning

confidence: 99%

A New Therapeutic Approach to Congenital Pelvic Arteriovenous Malformations

Houbballah

Mallios

Poussier

et al. 2010

Annals of Vascular Surgery

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“…Although easy to handle, relatively inexpensive and fast to act, it is not absorbed by the body and can impair bone healing [10] and as such should be used with caution. If used, it may be removed following haemostasis and avoided in areas of contamination as if left in situ can result in bone granuloma formation and may serve as a hub for infection [11].…”

Section: Bone Waxmentioning

confidence: 99%

A Review of Haemostasis Following Minor Oral Surgery Procedures

Ria¹

2017

JDHODT

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This paper focuses on the process of haemostasis and methods of aiding haemostasis following minor oral surgery; these include both local and systemic measures. Consideration is given to patients with bleeding disorders, on anticoagulant medication or antiplatelet medication. The importance of recognising the increased risk of haemorrhage following minor oral surgery in such patients is explored with current recommendations for good practice in such patients. The dilemma as to whether antiplatelet and anticoagulant medication should be continued or discontinued prior to or immediately following minor oral surgery procedures is also discussed. Clinical RelevanceHaemorrhage following minor oral surgery is to be expected; if left uninterrupted and persistent, can prove fatal. It is therefore essential to understand the process of haemostasis and methods one can use to aid haemostasis in such instances. Similarly, with a shift in population demographics and an increase in life expectancies, comes a surge in co-morbidities and new medication to tackle them; among them anticoagulant and antiplatelet medication. It is important to be aware of how these medications can affect our patients, and how to manage such patients to avoid unnecessary prolonged haemorrhage following minor oral surgery. ObjectiveTo explain the process of haemostasis and the different methods of aiding haemostasis following minor oral surgery procedures. To understand the importance of aiding haemostasis in patients with a bleeding disorder or on anticoagulant or antiplatelet medication and the role of secondary care.

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Haemostasis and Healing following Median Sternotomy

Cited by 17 publications

References 0 publications

Ostene, a New Alkylene Oxide Copolymer Bone Hemostatic Material, Does Not Inhibit Bone Healing

Ostene, a New Alkylene Oxide Copolymer Bone Hemostatic Material, Does Not Inhibit Bone Healing

A New Therapeutic Approach to Congenital Pelvic Arteriovenous Malformations

A Review of Haemostasis Following Minor Oral Surgery Procedures

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