PDF(Pubmed)
Abstract：
UNASSIGNED: The effect of bone wax on sternal infection and intraoperative bleeding in off-pump coronary surgery has not been reported in current literature.
UNASSIGNED: To prospectively evalute this in a cohort of high risk patients undergoing off-pump coronary artery surgery at our institution. The potential impact on cell saver utilization was also studied.
UNASSIGNED: A prospective randomized study was performed in 58 diabetic patients operated on for two-vessel coronary artery disease by the off-pump technique. They were randomly assigned to the wax or no-wax group.
UNASSIGNED: There was no significant difference in intraoperative blood loss between the wax (550 ml) and no-wax group (750 ml; p = 0.0711). In multivariate analysis the absence (non-use) of bone wax (odds ratio = 3.9 (1.12-13.51), p = 0.027) and preoperative creatinin level (odds ratio = 1.1 (0.99-1.03), p = 0.03) were identified as independent predictors of blood loss ≥ 750 ml. The number of red blood cell units during hospital stay was similar in both groups (p = 0.42). Wound healing complications were not observed in either group.
UNASSIGNED: The use of bone wax does not lead to a higher risk of sternal wound infection. It may reduce the risk of high intraoperative blood loss, thus avoiding the need of a cell saver during off-pump coronary surgery. However, this influence remains questionable.
UNASSIGNED: To prospectively evalute this in a cohort of high risk patients undergoing off-pump coronary artery surgery at our institution. The potential impact on cell saver utilization was also studied.
UNASSIGNED: A prospective randomized study was performed in 58 diabetic patients operated on for two-vessel coronary artery disease by the off-pump technique. They were randomly assigned to the wax or no-wax group.
UNASSIGNED: There was no significant difference in intraoperative blood loss between the wax (550 ml) and no-wax group (750 ml; p = 0.0711). In multivariate analysis the absence (non-use) of bone wax (odds ratio = 3.9 (1.12-13.51), p = 0.027) and preoperative creatinin level (odds ratio = 1.1 (0.99-1.03), p = 0.03) were identified as independent predictors of blood loss ≥ 750 ml. The number of red blood cell units during hospital stay was similar in both groups (p = 0.42). Wound healing complications were not observed in either group.
UNASSIGNED: The use of bone wax does not lead to a higher risk of sternal wound infection. It may reduce the risk of high intraoperative blood loss, thus avoiding the need of a cell saver during off-pump coronary surgery. However, this influence remains questionable.
摘要：
■骨蜡对非体外循环冠状动脉手术中胸骨感染和术中出血的影响在当前文献中尚未报道。
■在我们机构接受非体外循环冠状动脉手术的高危患者队列中进行前瞻性评估。还研究了对细胞节约利用的潜在影响。
■在58例糖尿病患者中进行了一项前瞻性随机研究。他们被随机分配到蜡组或无蜡组。
■蜡组（550ml）和无蜡组（750ml；p=0.0711）的术中失血量无显着差异。在多变量分析中，没有（不使用）骨蜡（比值比=3.9（1.12-13.51），p=0.027）和术前肌酐水平（比值比=1.1（0.99-1.03），p=0.03）被确定为失血量≥750ml的独立预测因子。两组住院期间的红细胞数量相似（p=0.42）。两组均未出现创面愈合并发症。
■使用骨蜡不会导致胸骨伤口感染的风险更高。它可以降低术中大量失血的风险，从而避免了在非体外循环冠状动脉手术期间需要细胞保护者。然而,这种影响仍然值得怀疑。
■在我们机构接受非体外循环冠状动脉手术的高危患者队列中进行前瞻性评估。还研究了对细胞节约利用的潜在影响。
■在58例糖尿病患者中进行了一项前瞻性随机研究。他们被随机分配到蜡组或无蜡组。
■蜡组（550ml）和无蜡组（750ml；p=0.0711）的术中失血量无显着差异。在多变量分析中，没有（不使用）骨蜡（比值比=3.9（1.12-13.51），p=0.027）和术前肌酐水平（比值比=1.1（0.99-1.03），p=0.03）被确定为失血量≥750ml的独立预测因子。两组住院期间的红细胞数量相似（p=0.42）。两组均未出现创面愈合并发症。
■使用骨蜡不会导致胸骨伤口感染的风险更高。它可以降低术中大量失血的风险，从而避免了在非体外循环冠状动脉手术期间需要细胞保护者。然而,这种影响仍然值得怀疑。
