Annemarie Brüel

The Influence of Hemostatic Agents on Bone Healing After Sternotomy in a Porcine Model

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

BACKGROUND: Sternotomy is the preferred access to the mediastinum. During sternotomy, trabecular bone is exposed, often resulting in bleeding, which can be treated with mechanical hemostatic agents; however, their influence on the healing process is relatively unexplored. The aim of this study was to investigate the influence of two hemostatic agents: bone wax (BW) and a water-soluble polymer wax, Ostene (WSW), on the mechanical and histologic characteristics of healing sternal bone.

METHODS: Twenty-four pigs underwent sternotomy and were randomized into three groups: WSW, BW, or no hemostatic treatment (control). Bone samples were obtained 6 weeks postoperatively.

RESULTS: Fracture strength (Fmax) and maximum stiffness (dF/dx) was lower in the BW group than in controls (Fmax :175.2 vs. 255.8N, dF/dx:165.2 vs. 375.4N/mm,) (p < 0.05). The stiffness did not differ statistically between the WSW and BW groups (298.4 vs 165.2 N/mm) nor did the fracture strength (211.4 vs 175.2 N). The fraction of granulomatous tissue was higher in the BW group compared with both the WSW group (79.1 vs. 16.52%) (p < 0.001) and controls (79.1 vs. 11.2%) (p < 0.001). There was more calcified tissue in controls than in the BW group (23.4 vs. 10.8%) (p < 0.05).

CONCLUSIONS: In a porcine model, BW significantly inhibited sternal healing and was associated with chronic inflammation and reduced mechanical integrity. The WSW did not, to the same degree as BW, inhibit bone healing and thus presents an alternative treatment option for sternal bleeding.

OriginalsprogEngelsk
TidsskriftAnnals of Thoracic Surgery
Vol/bind99
Nummer3
Sider (fra-til)1005-1011
Antal sider7
ISSN0003-4975
DOI
StatusUdgivet - 16 jan. 2015

Se relationer på Aarhus Universitet Citationsformater

ID: 84878799