Novel bone wax based on DCPA granules and modified starch for hemostasis and bone regeneration

Though acknowledged as the essential material in bone bleeding control with advantages of low cost, excellent malleability and smooth consistency for operation, traditional bone wax is associated with adverse effects such as foreign body reaction, granuloma growth, and bone healing failure. Herein, we presented a novel ready-to-use bone wax (NBW) based on DCPA (CaHPO4) granules (DCPA-G) and modified waxy starch (MWS), proposed to overcome problems of bone wax but preserving its impressive workability in hemorrhage control. Thanks to rheological and adhesive properties of MWS after exposure to water, NBW was found to be cohesive, malleable, water content dependent tissue adhesive and liquid sealing abilities. Moreover, after hardening under humid environment due to the interaction between MWS and DCPA-G, NBW exhibited compressive strength that is comparable to that of cancellous bone. After smeared to defect model, water leakage was avoided by NBW. Besides, this material showed superior hemostasis and osteogenesis ability over traditional bone wax in vitro. Simultaneously, in vivo tests confirmed the efficiency of NBW in bleeding control and bone regeneration, indicating it a promising candidate in bleeding bone treatment.