Annemarie Brüel

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

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The Influence of Hemostatic Agents on Bone Healing After Sternotomy in a Porcine Model. / Vestergaard, Rikke; Brüel, Annemarie; Thomsen, Jesper S; Hauge, Ellen M; Søballe, Kjeld; Hasenkam, J Michael.

I: Annals of Thoracic Surgery, Bind 99, Nr. 3, 16.01.2015, s. 1005-1011.

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

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@article{8f7d67020ca44b0385e3be4714289060,
title = "The Influence of Hemostatic Agents on Bone Healing After Sternotomy in a Porcine Model",
abstract = "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.",
author = "Rikke Vestergaard and Annemarie Br{\"u}el and Thomsen, {Jesper S} and Hauge, {Ellen M} and Kjeld S{\o}balle and Hasenkam, {J Michael}",
note = "Copyright {\textcopyright} 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.",
year = "2015",
month = jan,
day = "16",
doi = "10.1016/j.athoracsur.2014.10.016",
language = "English",
volume = "99",
pages = "1005--1011",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier Inc.",
number = "3",

}

RIS

TY - JOUR

T1 - The Influence of Hemostatic Agents on Bone Healing After Sternotomy in a Porcine Model

AU - Vestergaard, Rikke

AU - Brüel, Annemarie

AU - Thomsen, Jesper S

AU - Hauge, Ellen M

AU - Søballe, Kjeld

AU - Hasenkam, J Michael

N1 - Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

PY - 2015/1/16

Y1 - 2015/1/16

N2 - 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.

AB - 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.

U2 - 10.1016/j.athoracsur.2014.10.016

DO - 10.1016/j.athoracsur.2014.10.016

M3 - Journal article

C2 - 25601654

VL - 99

SP - 1005

EP - 1011

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 3

ER -