Evaluation of Feasibility of Hydroxyapatite Putty as a Local Hemostatic Agent for Bone

1. Evaluation of Feasibility of Hydroxyapatite Putty as a Local Hemostatic Agent for Bone Yukihiro Momota,1 Youji Miyamoto,1 Kunio Ishikawa,2 Masaaki Takechi,1 Tetsuya Yuasa,1Seiko Tatehara,1 Masaru Nagayama,1 and Kazuomi Suzuki3 1 First Department of Oral and Maxillofacial Surgery, School of Dentistry, Tokushima University 2 Department of Biomaterials, Faculty of Dental Science, Kyushu University 3 Division of Biomaterials, Department of Recovery and Reconstruction, Science of Functional Recovery and Reconstruction, Graduated School of Medicine and Dentistry, Okayama University Graduated School Received 24 September 2001; revised 11 February 2001; accepted 26 February 2002 指導老師：林鴻儒 學 生：劉聿豐 民國九十九年八月十六日

2. 前言 • 局部止血材料已廣泛應用於外科臨床，如氧化纖維素、凝膠、外用凝血酶。 • 骨蠟具有良好的止血能力，自1800多年已被用於局部骨頭的止血劑。 • 骨蠟是由蜂蠟、杏仁油、水楊酸所製成 • 據報導骨蠟的炎症會反應引起周圍組織有害影響骨組織，因此發展一個具有良好的生物相容性對骨頭是有利的。

3. 材料與方法 • tetracalcium phosphate • dicalcium phosphate anhydrous • disodium hydrogen phosphate • Sodium dihydrogen phosphate aqueous • sodium alginate

4. 實驗方法 (0, 2, 4,6, 8, and 10 WT %) of sodium alginate 0.2- MOL/L disodium hydrogen phosphate tetracalcium phosphate dicalcium phosphate anhydrous 0.2 mol/l sodium dihydrogen phosphate aqueous solution liquid phase powder phase + = 1：3.5 stored in a vacuum desiccator at 60 °C pH became 7.4 at 37 °C.

5. Figure 2. Schematic illustration of the measurement of adhesive strength of HAP putty or bone wax to bone. The maximum load to separate the bone from HAP putty after loading 78.4 N was used as an index of the adhesive strength.

6. Figure 3. Effects of sodium alginate concentration of HAP putty on the adhesive strength of HAP putty to dry and wet bone. Open circles, wet bone; solid circles, dry bone. The bars in the figure denote standard deviation. Asterisks indicate significant difference versus sodium alginate free specimens (n=5).

7. Figure 4. Amounts of bleeding for each minute after hemostatic procedure.Open circles, HAP putty; solid circles, bone wax; triangles,shamoperation.The bars in the figure denote standard deviation.Asterisks significant difference against sodium alginatebone wax groups (n=7).

8. Figure 5. Powder X-ray diffraction patterns. T: TTCP, D: DCPA, H: HAP. (a) HAP putty, (b) the powder phases of HAP putty, that is, an equimolar mixture of TTCP and DCPA, (c) bone apatite.

9. Figure 6. Light micrograph of rabbit abdominal subcutaneous tissue surrounding HAP putty two weeks after implantation. H-E staining; Magnification 31.

10. Figure 7. Light micrograph of rabbit abdominal subcutaneous tissue surrounding bone wax two weeks after implantation. H-E staining; Magnification 31.

11. 結論： 從圖3發現8wt%的海藻酸鈉再濕骨與乾骨的黏合強度為較高。而骨蠟用於濕骨的黏合強度有非常小的黏合強度8.3N，HAP Putty不管在濕骨或乾骨都明顯比骨蠟高出很多。 從圖4可看出HAPPUTTY在3分鐘內能停止出血 ，骨蠟停止出血時間為8分鐘內。 從圖6和圖7可看出骨蠟的炎症反應明顯高於HAP Putty。 故HAP Putty 是有效的做為止血、生物相容性好的修護材料。