Does lengthening after acute correction negatively affect bone healing during distraction osteogenesis?

Background Sternotomy is a standard approach performed in almost every surgical procedure on the heart and mediastinum. Effective hemostasis of the sternum is required to keep the operative field dry, avoid excessive blood transfusions during surgery, and prevent reoperation due to massive postoperative bleeding, which can further increase morbidity and mortality in patients. Bone wax is a mechanical hemostat commonly used after sternotomy and has been known to affect bone healing, trigger chronic inflammatory reactions, and increase the rate of infection. The application of chitosan, which has intrinsic hemostat ability, as hemostatic material is believed to improve bone healing following sternotomy. This study aimed to compare the effectiveness of bone wax and chitosan on bone healing after sternotomy. Methods Median sternotomies were performed on 2 groups of New Zealand White rabbits. Each group of 16 animals received either bone wax or chitosan powder as hemostatic material. The degree of bone healing, the number of foreign-body giant cells, and the number of osteoblasts were evaluated after 6 weeks. Results Radiographs showed that significantly more animals in the chitosan group had total sternal healing ( p = 0.033). Histopathology revealed that the number of foreign-body giant cells was significantly less ( p = 0.036) and the number of osteoblasts was significantly greater ( p < 0.0001) in the group of animals that received chitosan. Conclusion The use of chitosan as hemostatic material can promote better bone healing compared to bone wax.

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???Mapping the Gap???: Combined Histologic and ??CT Assessment of Bone Healing During Mandibular Distraction Osteogenesis

Plastic & Reconstructive Surgery ◽

10.1097/00006534-200509011-00140 ◽

2005 ◽

Vol 116 (Supplement) ◽

pp. 171-172 ◽

Cited By ~ 1

Author(s):

Daniel Adam Schwarz ◽

Ayman Elmeligy ◽

Krikor G. Arman ◽

Michael J. Plakke ◽

Steven R. Buchman

Keyword(s):

Distraction Osteogenesis ◽

Bone Healing ◽

Mandibular Distraction ◽

Mandibular Distraction Osteogenesis

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Changes in blood perfusion and bone healing induced by nicotine during distraction osteogenesis

Bone ◽

10.1016/j.bone.2008.04.002 ◽

2008 ◽

Vol 43 (2) ◽

pp. 355-361 ◽

Cited By ~ 58

Author(s):

Li Wu Zheng ◽

Li Ma ◽

Lim Kwong Cheung

Keyword(s):

Distraction Osteogenesis ◽

Bone Healing ◽

Blood Perfusion

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Bone Healing and Inflammation: Principles of Fracture and Repair

Seminars in Plastic Surgery ◽

10.1055/s-0041-1732334 ◽

2021 ◽

Vol 35 (03) ◽

pp. 198-203

Author(s):

Hassan ElHawary ◽

Aslan Baradaran ◽

Jad Abi-Rafeh ◽

Joshua Vorstenbosch ◽

Liqin Xu ◽

...

Keyword(s):

Bone Remodeling ◽

Bone Healing ◽

Cell Activation ◽

Improve Patient Care ◽

Phosphate Homeostasis ◽

Integral Role ◽

Bony Fixation ◽

Improve Patient ◽

Affect Bone Healing ◽

Biomechanical Instability

AbstractBones comprise a significant percentage of human weight and have important physiologic and structural roles. Bone remodeling occurs when healthy bone is renewed to maintain bone strength and maintain calcium and phosphate homeostasis. It proceeds through four phases: (1) cell activation, (2) resorption, (3) reversal, and (4) bone formation. Bone healing, on the other hand, involves rebuilding bone following a fracture. There are two main types of bone healing, primary and secondary. Inflammation plays an integral role in both bone remodeling and healing. Therefore, a tightly regulated inflammatory response helps achieve these two processes, and levels of inflammation can have detrimental effects on bone healing. Other factors that significantly affect bone healing are inadequate blood supply, biomechanical instability, immunosuppression, and smoking. By understanding the different mechanisms of bone healing and the factors that affect them, we may have a better understanding of the underlying principles of bony fixation and thereby improve patient care.

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