Bone Wax and Osteophytes and What Your Surgeon May Not Tell You

[ADR seeker]

Your butcher/surgeon may have told you that removing bone to alleviate stenosis will only cause the bone to grow back. He's lying or uninformed or both.

Bone wax - Wikipedia, the free encyclopedia

Bone wax is made of beeswax containing a softening agent such as paraffin. Bone wax is used to mechanically stop bone bleeding during surgical procedures. The bone wax is smeared across the bleeding edge of the bone, blocking the holes and causing immediate bone hemostasis through a tamponade effect. Bone wax is supplied in sterile sticks, and most often requires softening before it can be applied. Once applied, it essentially never goes away. Although inexpensive, easy to use and immediate, bone wax has a number of adverse reactions associated with it.

Bone wax inhibits formation of new bone osteogenesis and acts as a physical barrier preventing bone union.

In the presence of bone wax, osteoblasts will be absent in a bone defect.[3] In defects where bone wax was applied and removed after 10 minutes, there was complete inhibition of bone regeneration.[4] For this reason bone wax is almost never used in areas where bone fusion is critical.[5]

Bone wax increases infection rates and impairs the ability of bone to clear bacteria.[6] In the presence of bone wax, the number of bacteria needed to produce osteomyelitis is reduced by a factor of 10,007. In a recent study of infection rates following spinal surgery, surgical site infections occurred in 6 of 42 cases in which bone wax was used, and in only 1 of 72 cases in which it was not used.[7]

Infection and non-union are a particularly important problem in cardiac surgery.[8] According to the American Heart Association, the incidence of deep sternal wound infections is 1% to 5% of patients undergoing coronary artery bypass surgery, with a mortality rate of about 25%.[9]

Bone wax remains as a foreign body for many years, and can cause a giant cell reaction and local inflammation.[10] In skull base surgery, bone wax has been reported to cause granuloma formation and CSF fluid leaks.

The FDA has recently approved a new water soluble bone hemostasis material called Ostene, which is designed to look and feel like bone wax.[13] This material comprises a sterile mixture of water-soluble alkylene oxide copolymers, derived from ethylene oxide and propylene oxide. These copolymers have a long history in the medical and pharmaceutical fields, and they are considered inert. These compounds are not metabolized, but eliminated from the body unchanged. It is anticipated that with the introduction of these new hemostatic materials, the incidence of surgical bone infections, nonunion and inflammatory complications will decrease with time.

[mmglobal]

I've seen bone wax used many times, but in only one situation. When anterior osteophytes are being removed because they may interfere with swallowing after ADR surgery, the surgeon uses bone wax so that site does not release the osteoblasts that will lead to more bone growth and possible auto fusion. Other sites that are ground away with the high speed burr is not treated with bone wax, because they'll be 'sealed' with the prosthesis completely covering them.

Following this, bone wax will only be used in much more severe cases with much more work being done. This will lead to longer OR times and more invasive interventions. I don't know if the reference was to spine surgery, but comparing bone wax cases to non-bone wax cases is not comparing like surgeries. That may account for the difference in infection rates. Also, infection rates vary widely from surgeon to surgeon. I would be interested in learning more about the subtleties of the data.

If there was grinding of anterior osteophytes in my neck surgery, I hope that bone wax was applied.

Mark

[ADR seeker]

Nosocomial infection are rampant in the US. Based on what gets reported over 2 million Americans get a health care acquired infection and over 100,000 of them die. The odds of getting one is 1 in 10.

Bone wax is bees wax. Bees wax in the raw is loaded with salmonila and E. coli. I would think that sterilizing it and adding antibiotics would solve the infection problem. This reminds me of the thinking when chemo=papian was used to shrink disk but it was stopped because some people had allergic reactions to it... atleast that was the reason/excuse given for not using it.

I needed and MRI and CAT scan and they wanted me to sign a release for a dye injection. They dye has serious side effect is more than 1 in 100 cases and the image enhancement is questionable yet it is used because GE makes it.

Bone was is used to stop bleeding from the bone. It can be irradiated and made 100% sterile my guess is it that some of it is deliberately contaminated so that a synthetic patentable substitute can be sold at an obscene profit.