Does Bone Wax Increase Sternotomy Wound Infection? A Single Center Experience

Introduction: Median sternotomy can result in significant bleeding, and the application of bone wax helps to control bleeding on the cut edges of the bones. Increasing evidence suggests that bone wax potentially increases the risk of postoperative sternal dehiscence. We aim to investigate whether or not the use of bone wax will increase sternal wound infection rate. Methods: In a retrospective cohort study with propensity score matching conducted on 390 patients undergoing elective isolated coronary artery bypass grafting (CABG), there were 195 patients each in the bone wax group and non-bone wax group. The demographics and perioperative data were collected and compared using statistical analysis. Results: The demographics and perioperative data such as diabetic status, smoking, pulmonary diseases, bypass and cross clamp time of both the groups were similar (P>0.05). The number of superficial sternal wound infection in bone wax group was 4, whereas in the non-bone wax group was 6, this result was not statistically significant (P=0.5). Conclusion: The use of bone wax does not increase sternal wound infection rate. However further randomized controlled trials with larger sample size are needed to verify this result.