Syringe tip accuracy for application of Victor Horsley's bone wax

Design and Development of a Cost-Effective Transnasal Skull Base Bone Wax Applicator: A Technical Note

Bone wax is an important hemostatic agent used in neurosurgical practice from more than a century. It acts by mechanical tamponade effect to stop the oozing from cancellous bone. Bone wax application over the skull surface over the vertex is easy and can be applied with fingers. In deeper areas, one uses dissector to apply the bone wax; however, it becomes difficult at times to apply in transnasal surgery using the same dissectors. Author designed a cost-effective 20-cm-long different angled bone wax applicator for skull base transnasal surgery. This applicator is cost-effective and not described previously in English literature.

Topical hemostatic agents: a review

Topical hemostatic agents play an important role in both common and specialized dermatologic procedures. These agents can be classified based on their mechanism of action and include physical or mechanical agents, caustic agents, biologic physical agents, and physiologic agents. Some agents induce protein coagulation and precipitation resulting in occlusion of small cutaneous vessels, while others take advantage of latter stages in the coagulation cascade, activating biologic responses to bleeding. Traditional and newer topical hemostatic agents are discussed in this review, and the benefits and costs of each agent will be provided.