Does bone wax make sense in off-pump coronary surgery? A prospective randomized study

• Published in: Kardiochirurgia i torakochirurgia polska Vol. 20; no. 2; pp. 67 - 71
• Main Authors: Sorm, Zdenek, Vobornik, Martin, Dergel, Martin, Cermakova, Eva, Harrer, Jan, Gofus, Jan
• Format: Journal Article
• Language: English
• Published: Poland Termedia Publishing House 01.06.2023
• Subjects: blood transfusion; coronary artery bypass graft surgery; off-pump surgery; Original Paper; sternum; wound healing; coronary artery bypass graft surgery; blood transfusion; wound healing; sternum; off-pump surgery
• ISSN: 1731-5530; 1897-4252
• DOI: 10.5114/kitp.2023.129551

The effect of bone wax on sternal infection and intraoperative bleeding in off-pump coronary surgery has not been reported in current literature. To prospectively evalute this in a cohort of high risk patients undergoing off-pump coronary artery surgery at our institution. The potential impact on cell saver utilization was also studied. A prospective randomized study was performed in 58 diabetic patients operated on for two-vessel coronary artery disease by the off-pump technique. They were randomly assigned to the wax or no-wax group. There was no significant difference in intraoperative blood loss between the wax (550 ml) and no-wax group (750 ml; = 0.0711). In multivariate analysis the absence (non-use) of bone wax (odds ratio = 3.9 (1.12-13.51), = 0.027) and preoperative creatinin level (odds ratio = 1.1 (0.99-1.03), = 0.03) were identified as independent predictors of blood loss ≥ 750 ml. The number of red blood cell units during hospital stay was similar in both groups ( = 0.42). Wound healing complications were not observed in either group. The use of bone wax does not lead to a higher risk of sternal wound infection. It may reduce the risk of high intraoperative blood loss, thus avoiding the need of a cell saver during off-pump coronary surgery. However, this influence remains questionable.