Hemostasis can be achieved by mechanical occlusion with petrolatum and gauze after cutaneous surgery, known as a pressure bandage. However, difficulty applying a pressure bandage in certain scenarios, like bone bleeding or irregularly shaped areas, necessitates alternative hemostatic measures. In such instances, physical hemostatic agents, like gelatin, oxidized cellulose, microporous polysaccharide spheres, hydrophilic polymers with potassium salts, microfibrillar collagen, and chitin also can be used. Nevertheless, those agents are expensive and often adhere to wound edges, generating repeat trauma with removal. To avoid such concerns, researchers have recently proposed using bone wax as an effective hemostatic technique. It can be applied immediately following surgery and removed during bandage change.

Bone wax has several advantages; such as, it is not absorbed and does not adhere to wound surfaces, making removal easy and painless. Furthermore, it also allows for excellent growth of granulation tissue, probably due to the healing and emollient properties of the beeswax and the moist occlusive environment created by the bone wax. Its additional advantages are low cost and long shelf-life. Furthermore, bone wax can prevent air emboli from entering noncollapsible emissary veins when cutaneous tumors extend into the calvarium.

Fritsche M, Wirth P, Lam C. Bone Wax as a Physical Hemostatic Agent. Cutis. 2023 February;111(2):82-83. doi:10.12788/cutis.0694