Using bone wax for hemostasis tied to allergic reactions, granuloma development and disruption of bone healing: Case study

Written by Dr Supreeth D R Published On 2025-01-01T20:30:55+05:30 | Updated On 2 Jan 2025 3:05 PM IST

Using bone wax for hemostasis tied to allergic reactions, granuloma development and disruption of bone healing: Case study

Osseous hemorrhage following a surgical incision or traumatic fracture can be a challenging issue to manage.

During orthopedic surgeries, bone wax is frequently utilized as a surgical technique to enhance hemostasis and reduce bleeding from bone. The hemostatic effect of bone wax mostly stems from its physical characteristics. The advantages of using bone wax are that it is easy to handle, low cost, inert, malleable, and has good sealing capacity and bone adherence. A review of the literature also shows that the most notable side effects of using bone wax are allergic foreign body reactions, development of granulomas, infection, and disruption of bone healing.

Samyabrata Das et al reported two cases of exostosis where the main surgical procedure for exostosis excision involved the use of bone wax to achieve hemostasis. A few months later, they presented with delayed migration and discharge of bone wax from the site of the surgery. To remove the bone wax off the primary application site, both of these individuals needed surgical intervention.

The article has been published in ‘Journal of Orthopaedic Case Reports.’

The authors opined - “When needed, bone wax should only be applied for the duration required to bring about hemostasis. Although it has several drawbacks, bone wax is an important surgical material. Surgeons must weigh the advantages of using it against any possible hazards. Careful observation is required after surgery to manage any possible complications. It acts as a foreign body; hence, using bone wax may result in foreign-body granulomas. Bone wax is a cost-effective, user-friendly, and promptly efficient hemostatic substance; nevertheless, its advantages should not be blindly used without prior assessment of the associated hazards. In conclusion, even though bone wax is very frequently used in Orthopedic surgeries to help with hemostasis and control bony bleeding, medical personnel must be aware of any possible risks involved with it. It is essential to closely follow individuals who have received bone wax treatment to address any issues or problems. To guarantee the best possible outcomes for their patients, surgical teams must remain up to date on the newest advancements and available options in hemostatic agents.”

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.