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Commentary

Commentary I congratulate the authors on a well-done study involving Ostene. Ostene (water-soluble alkylene oxide copolymers), a synthetic bone hemostatic agent, was evaluated in a rabbit model (18 rabbits) where it was applied to a bone defect in the iliac crest. The animals were placed into 3 groups: (1) bone wax, (2) treated with Ostene, (3) no treatment. Laboratory studies sequentially evaluated WBC, CRP, and ESR obtained at 0, 1, 3, and 6 weeks after the procedures; animals were killed at 6 postoperative weeks. A group 4 was also created (6 rabbits) and was evaluated following the application of Ostene alone, and BUN and creatinine studies were obtained to rule out systemic nephrotoxicity. Laboratory studies (WBC, CRP, and ESR) in the animals in groups 1 to 3 remained normal postoperatively. The amount of postoperative blood loss at the surgical sites in group 2 rabbits was slightly but not significantly greater than for group 1 rabbits, whereas those in group 3, where no hemostatic agent was used, sustained a greater local blood loss. Histologic evaluations revealed that group 1 subjects exhibited fibrosis at the site where bone wax was used, group 2 animals demonstrated no Ostene residua, and groups 2 and 3 demonstrated no fibrotic tissue at the bone defect sites. Furthermore, there were no systemic changes in BUN and CRP in group 4 animals. The authors concluded that Ostene reabsorbs and is not associated with any systemic toxicity or inflammatory local tissue reaction as tested in a rabbit animal model. In summary, Ostene would appear to be an extremely useful alternative to bees wax, because the latter is responsible for a significant inflammatory response (remains in situ for more than a 10-year period and becomes encapsulated with fibrotic tissue), and inhibits new bone formation. This is an excellent study, is clear, and is well thought of. Furthermore, it should prompt spinal surgeons to choose Ostene instead of bone (bees) wax in the future.</P> http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Surgical Neurology Elsevier
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