Water Soluble Bone Hemostatic Agent, Was It Effective In Reducing Post-Sternotomy Wound Infection?

Background: The widely utilized Bone Wax (BW) in sealing sternal wound edges is a well-known risk factor for delayed healing and post-sternotomy wound infection, and despite the variety of bone sealants available, we have little data on their effectiveness and safety in sternal wound hemostasis.
Objective: This study aimed to assess effectiveness and safety of water-soluble bone wax (WSW; Ostene^® or Tableau Wax^®) hemostatic agents as alternative for the ordinary bone wax (BW).
Methods: This study included 323 patients who underwent elective cardiac surgeries via median sternotomy at Kasr-Alainy, Fayoum, and Beniseuf University Hospitals through the period from January 2020 to September 2024. They were divided into two groups: Group A (the control or BW group), which had 165 patients, and group B (the WSW group), which had 158 patients. Postoperative data regarding clinical and radiological signs of wound healing and infection were gathered and analyzed.
Results: The WSW group had a significantly decreased incidence of superficial (12 vs. 25) and deep sternal wound infection (DSWI; 2 vs. 9), as well as a shorter hospital stay (5.8 ± 3.4 vs. 6.7 ± 4.5 days). A trimonthly radiologic follow-up showed that the BW group had considerably worse sternal bone repair than the WSW group (p < 0.0001).
Conclusion: Whenever necessary, topical sternal edge hemostasis could be securely and effectively done with water-soluble bone sealants with superior surgical outcomes.