eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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2/2023
vol. 20
 
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abstract:
Original paper

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

Zdenek Sorm
1
,
Martin Vobornik
1
,
Martin Dergel
1
,
Eva Cermakova
2
,
Jan Harrer
1
,
Jan Gofus
1

  1. Department of Cardiac Surgery, Charles University, Faculty of Medicine and University Hospital in Hradec Kralove, Czech Republic
  2. Department of Medical Biophysics, Faculty of Medicine in Hradec Kralove, Charles University, Czech Republic
Kardiochirurgia i Torakochirurgia Polska 2023; 20 (2): 67-71
DOI: https://doi.org/10.5114/kitp.2023.129551
Online publish date: 2023/07/26
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Introduction:
The effect of bone wax on sternal infection and intraoperative bleeding in off-pump coronary surgery has not been reported in current literature.

Aim:
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.

Material and methods:
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.

Results:
There was no significant difference in intraoperative blood loss between the wax (550 ml) and no-wax group (750 ml; p = 0.0711). In multivariate analysis the absence (non-use) of bone wax (odds ratio = 3.9 (1.12–13.51), p = 0.027) and preoperative creatinin level (odds ratio = 1.1 (0.99–1.03), p = 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 (p = 0.42). Wound healing complications were not observed in either group.

Conclusions:
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.

keywords:

off-pump surgery, coronary artery bypass graft surgery, blood transfusion, sternum, wound healing
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