Wellisz Tadeusz, Armstrong Jonathan K, Cambridge John, An Yuehuei H, Wen Xuejun, Kang Qian, Hill Christopher M, Fisher Timothy C
Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Ann Thorac Surg. 2008 May;85(5):1776-80. doi: 10.1016/j.athoracsur.2007.11.042.
This study compares the effects of a soluble polymer hemostatic material and bone wax on sternal bone healing.
Median sternotomies were performed on 20 New Zealand White rabbits, and sufficient polymer (Ostene; Ceremed Inc, Los Angeles CA) or bone wax (Bone Wax; Ethicon Inc, Somerville, NJ) was applied to achieve bone hemostasis. After 6 weeks, sternal healing was assessed using roentgenograms, histology, and mechanical strength testing.
Roentgenograms revealed normal bone healing in the polymer-treated group and nonunion in the bone wax group. Histology showed normal bone healing in the polymer group, with fibrotic scar tissue and the absence of new bone formation in the bone wax group. Mechanical strength testing showed that polymer-treated sternal segments were twice as strong as those treated with bone wax. They had a significantly higher flexural strength (2.53 +/- 0.43 vs. 1.29 +/- 0.37 megapascal [MPa]; p < 0.001) and Young's modulus (0.315 +/- 0.056 vs 0.146 +/- 0.031 MPa; p < 0.001).
The application of the polymer hemostatic material to the sternum resulted in significantly stronger union compared with the use of bone wax.
本研究比较可溶性聚合物止血材料和骨蜡对胸骨骨愈合的影响。
对20只新西兰白兔进行正中胸骨切开术，并应用足够的聚合物（Ostene；Ceremed公司，加利福尼亚州洛杉矶）或骨蜡（骨蜡；Ethicon公司，新泽西州萨默维尔）以实现骨止血。6周后，使用X线片、组织学和机械强度测试评估胸骨愈合情况。
X线片显示聚合物治疗组骨愈合正常，骨蜡组骨不连。组织学显示聚合物组骨愈合正常，骨蜡组有纤维化瘢痕组织且无新骨形成。机械强度测试表明，聚合物处理的胸骨节段强度是骨蜡处理节段的两倍。它们的抗弯强度（2.53±0.43对1.29±0.37兆帕[MPa]；p<0.001）和杨氏模量（0.315±0.056对0.146±0.031MPa；p<0.001）显著更高。
与使用骨蜡相比，将聚合物止血材料应用于胸骨可导致更强的骨愈合。
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