ترجمه مقاله نقش ضروری ارتباطات 6G با چشم انداز صنعت 4.0
- مبلغ: ۸۶,۰۰۰ تومان
ترجمه مقاله پایداری توسعه شهری، تعدیل ساختار صنعتی و کارایی کاربری زمین
- مبلغ: ۹۱,۰۰۰ تومان
It has been 125 years since the so-called initial use of bone wax (BW) by Sir Victor Horsley, and a review of this age-old hemostatic agent seems appropriate. The first use of BW for hemostasis occurred in the eighteenth century, when modeling or candle wax was used for hemostasis. Although the pioneers in the use of BW in craniofacial surgeries were Jean Louis Belloq, Khristian Khristianovich Salomon, and François Magendie, the first successful use in neurosurgery was demonstrated by Henri Ferdinand Dolbeau in 1864 after extirpation of a frontal osteoma. This technique was further popularized by Sir Victor Alexander Haden Horsley, the father of British neurosurgery, who is often incorrectly mentioned as the inventor of BW. Originally derived from beeswax, the currently available commercial preparation also contains paraffin wax and isopropyl palmitate. The main action being mechanical tamponade, BW has found several other uses in neurosurgery, other than being a hemostatic agent. Although it is cost-effective, the use of BW is associated with several complications also, including ineffective bone healing and infection. Several alternatives are being developed, but none are yet a full replacement for “Horsley’s wax.
CONCLUSION
Despite BW being useful in controlling massive bone bleeding and being the only hemostat of choice in certain situations, its use is limited by several complications. The following recommendations can be proposed regarding the use of BW in neurosurgery. It can be used in massive bleeding from diploic veins during cranial surgery, just at the site of bleeding. The use of BW in a large quantity is, however, not recommended. Its use is desirable if the patient is having coagulopathy. It is better to restrict its use in spine surgery, where fusion is desired. BW alternatives can be used instead. For minor bleeding from the bone surface or edges during craniotomy, monopolar cautery at a high ampere setting is a good, cost-effective alternative. Some agents have been recently marketed, claiming to overcome one of the disadvantages of bone wax— impaired bone healing. Additional trials are needed to validate the efficacy of these agents versus BW.