Histologically verified bone wax (beeswax) granuloma after median sternotomy in 17 of 18 autopsy cases
Histologically verified bone wax (beeswax) granuloma after median sternotomy in 17 of 18 autopsy cases
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18 例尸检病例中的 17 例在胸骨正中切开术后经组织学证实骨蜡（蜂蜡）肉芽肿
DOI：
10.1080/00313020600561732
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
E. Sudmann
中科院分区：
文献类型：
--
作者：
B. Sudmann;Gisle Bang;E. Sudmann
目的：对胸骨正中线皮肤瘢痕的普通尸检和法医尸检病例的胸骨进行大体和显微观察，并用CT检测胸骨正中切开术后是否使用止血骨蜡(蜂蜡)，以及骨蜡是否引起炎症。方法：对18具死前行胸骨正中切开手术的身体(普通尸检15具，法医尸检3具)连续3年的胸骨进行大体、显微及CT检查。另取1例处女胸骨，在胸骨板凳切开后上半部涂抹骨蜡，缝合后行CT检查。未使用的骨蜡用CT进行衰减测量。结果：肉眼可见18个胸骨中有17个出现骨蜡。急性炎症1例，慢性炎症17例，骨蜡周围可见异物多核巨细胞。1例未见炎症反应。CT仅能检出手术胸骨的病灶，其衰减值为−45~+20Hounsfield单位(HU)，处女胸骨的衰减值约为−80HU。未使用的骨蜡约为−100HU。结论：骨蜡是不可吸收的，使用后10年会在手术胸骨引起慢性炎症。手术侧胸骨CT测量Hounsfield单位不能证实骨蜡肉芽肿。
Aim: To evaluate the sternum from ordinary or forensic autopsy cases with a midline sternal cutaneous scar macro‐ and microscopically and using computed tomography (CT) to detect if the haemostatic bone sealant bone wax (beeswax) had been applied after median sternotomy and if the bone wax had elicited inflammation. Methods: During a 3‐year period, the sterna of 18 consecutive cadavers (15 ordinary autopsies, 3 forensic) who prior to death had undergone surgery with median sternotomy were examined macro‐ and microscopically and with CT. In addition, one virgin sternum was smeared with bone wax at the upper half after bench sternotomy, sutured and examined with CT. Unused bone wax was examined with CT for attenuation measurements. Results: Macroscopically, bone wax was seen in 17 of 18 sterna. Acute inflammation was found in one, chronic inflammation and foreign body multinucleated giant cells were seen around the bone wax in 17 sterna. No inflammation was found in one. CT could only detect foci in the operated sterna with attenuation values from −45 to +20 Hounsfield units (HU) and values about −80 HU were found in the virgin sternum. Unused bone wax measured about −100 HU. Conclusions: Bone wax is non‐resorbable and induces chronic inflammation in the operated sternum up to 10 years after application. Measurement of Hounsfield units with CT of the operated sterna could not verify bone wax granuloma.