Foreign body reaction to bone wax an unusual cause of persistent serous discharge from iliac crest graft donor site and the possible means to avoid such complication - a case report

Abstract

Introduction: Bone wax is sometimes used in a variety of surgical procedures as a haemostatic. Bone wax contains beeswax softened with isopropyl palmitate or paraffin. It is nonabsorbable with no biochemical action. It achieves haemostasis by occluding the blood channels mechanically. Once applied it essentially never goes away. Bone wax reactions have been reported in literature many times.

Case presentation: We report a case in which bone wax was used to control bleeding at the iliac crest from which bone graft was harvested. The foreign body reaction to bone wax caused persistent discharge from iliac crest graft donor site.

Conclusion: Bone wax is a foreign body and that there is always a possibility of foreign body granulomas following its use. When necessary, bone wax should be used just for the time needed to achieve hemostasis. If it is left in place, care should be taken to avoid bone wax accumulation in the bony craters formed during surgery. Applying bone wax as a smooth layer may lead to this lumpy formation in the bony craters and one should be careful about it.

Figure 1

Pieces of bone wax curetted out from the bony craters.

Figure 2

Pieces of bone wax curetted out from the bony craters.