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Ann Thorac Surg 1981;31:357-359
© 1981 The Society of Thoracic Surgeons

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Articles

The Embolization of Bone Wax from Sternotomy Incisions

Department of Thoracic and Cardiovascular Surgery, the Heineman Foundation Laboratory, Charlotte Memorial Hospital and Medical Center, Charlotte, NC, and from the Department of Pharmacology, University of London, King's College, London, England

^* Address reprint requests to Dr. Robicsek, The Sanger Clinic, PO Box 220868, Charlotte, NC 28207

We discuss our study on the effects of discontinuation of the usage of bone wax as a hemostatic agent in sternotomy incisions. In 1976, we abandoned use of bone wax because it was suspected of causing several cases of Mycobacterium fortuitum sternal osteomyelitis. In a retrospective study involving 400 patients, we found that this step did not increase postoperative bleeding as measured by drainage from the chest tube and by the need to return patients to the operating room because of bleeding. It also was observed that there was an appreciable simultaneous drop in pulmonary complications. To test our theory that the wax pressed into the bone marrow can embolize to the lung, radioactively tagged bone wax was pressed into the cut sternum in animal models, and a search was made for radioactive deposits in the peripheral lung tissue. Shortly after the application of the wax, there was evidence of large radioactive deposits in the lungs. It is probable that this embolization occurs also under clinical conditions and may play a role in pulmonary complications following open-heart operations.

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