مقاله انگلیسی رایگان در مورد وکس استخوان در جراحی مغز و اعصاب – الزویر 2018

INTRODUCTION

Bone wax (BW) is a widely used hemostatic agent in both cranial and spinal surgeries. It is mesmerizing to watch the heavy gush of blood from a diploic vein during a craniotomy being controlled by the prompt application of BW. Frequently, however, BW is used unnecessarily to control minute bone bleeding. Thus, a question has been raised in several specialties and surgeries, especially spine surgeries: Is the use of BW really indicated? This question is important because the use of BW has been associated with numerous complications, especially defective bone healing. Hence, many other alternatives are being developed and tried. We aim to review all the characteristics, uses, and complications associated with the use of BW, especially in relation to neurosurgery.

HISTORY

Henri-Ferdinand Dolbeau (1830e1877), the Professor of External Pathology and Surgeon of Paris Hospitals, was the first person to use BW for neurosurgery. He was the first surgeon to extirpate a frontal osteoma and use BW for the same in 1864.1 For experimental purposes in closing the venous sinuses, even Magendie (1783e1855) had used BW previously.2 It has been documented that unadulterated beeswax was used for amputation stump hemostasis during the American Civil War (1861e1865).3 Sir Victor Alexander Haden Horsley (1857e 1916) popularized the use of BW as a hemostatic agent after experimenting on cranial bones of dogs in 1885.4 He modified his preparation of BW with the help of an Oxford Street pharmacist named P.W. Squire, as the original one was not meeting the standard of modeling wax.5 The first documented use of this modified BW was by Rushton Parker, who reported its use in craniocervical surgery in 1892 for chronic suppurative otitis media with sigmoid sinus and jugular vein thrombosis.6 Since this period, the term Horsley’s wax remained synonymous with BW, although several modifications in its composition occurred over 125 years. Many Russian neurosurgeons argue that the formulation was developed and introduced into neurosurgery as early as the 1850s by surgeons in Moscow. In addition, some hospitals in Russia continue to prepare beeswax according to the original nineteenth-century formula.7 In the 1924 edition of Carson’s Modern Operative Surgery, the use of BW is recommended not for bone hemostasis— the currently prevalent application—but for preventing bone healing and for the creation of a pseudoarthrosis.8 There has not been a significant change in the formulation of BW since 1924. The material is still composed of insoluble and nonresorbable beeswax softened with paraffin or isopropyl palmitate, or both.