title: The effects of surgicel and bone wax hemostatic agents on bone healing: An experimental study.
abstract: BACKGROUND
  The biological effects of hemostatic agends on the physiological healing process need to be tested. The aim of this study was to assess the effects of oxidized cellulose (surgicel) and bone wax on bone healing in goats' feet.
  
  
  METHODS
  Three congruent circular bone defects were created on the lateral aspects of the right and left metacarpal bones of ten goats. One defect was left unfilled and acted as a control; the remaining two defects were filled with bone wax and surgicel respectively. The 10 animals were divided into two groups of 5 animals each, to be sacrificed at the 3(rd) and 5(th) week postoperatively. Histological analysis assessing quality of bone formed and micro-computed tomography (MCT) measuring the quantities of bone volume (BV) and bone density (BD) were performed. The results of MCT analysis pertaining to BV and BD were statistically analyzed using two-way analysis of variance (ANOVA) and posthoc least significant difference tests.
  
  
  RESULTS
  Histological analysis at 3 weeks showed granulation tissue with new bone formation in the control defects, active bone formation only at the borders for surgicel filled defects and fibrous encapsulation with foreign body reaction in the bone wax filled defects. At 5 weeks, the control and surgicel filled defects showed greater bone formation; however the control defects had the greatest amount of new bone. Bone wax filled defects showed very little bone formation. The two-way ANOVA for MCT results showed significant differences for BV and BD between the different hemostatic agents during the two examination periods.
  
  
  CONCLUSIONS
  Surgicel has superiority over bone wax in terms of osseous healing. Bone wax significantly hinders osteogenesis and induces inflammation.
authors.affiliation: Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia ; Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, 3D Imaging and Biomechanical Lab. College of Biomedical Applied Science, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Nasser
authors.initials: N
authors.lastname: Nooh
authors.affiliation: Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia ; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Egypt.
authors.forename: Walid A
authors.initials: WA
authors.lastname: Abdullah
authors.affiliation: Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia ; Department of Oral Biology, Faculty of Dentistry, Mansoura University, Egypt.
authors.forename: Mohammed El-Awady
authors.initials: Mel-A
authors.lastname: Grawish
authors.affiliation: Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Sundar
authors.initials: S
authors.lastname: Ramalingam
authors.affiliation: Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia ; Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, 3D Imaging and Biomechanical Lab. College of Biomedical Applied Science, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Fawad
authors.initials: F
authors.lastname: Javed
authors.affiliation: Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia ; Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, 3D Imaging and Biomechanical Lab. College of Biomedical Applied Science, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Khalid
authors.initials: K
authors.lastname: Al-Hezaimi
keywords: Bone defects; bone wax; goat; histology; micro-computed tomography; oxidized cellulose