哈尔滨工业大学李保强教授课题组在《J. Mater. Chem. B》发表了题为《Component design and functionalization of absorbable bone wax: from bench to bedside》的综述文章，系统梳理了可吸收骨蜡在成分设计与功能化领域的最新研究进展。
针对传统骨蜡不可吸收、易引发炎症及阻碍骨愈合等临床痛点，李保强教授团队深度剖析了新型生物降解材料的筛选逻辑，并详细阐述了如何通过功能化手段赋予骨蜡抗菌、抗炎及诱导骨再生等“智能”属性。该研究不仅打通了从基础实验（Bench）到临床转化（Bedside）的关键技术路径，更为下一代高性能骨修复材料的产业化应用提供了科学指引。[1]
以下内容节选自该研究论文的核心章节。
通过梳理这些关键段落，我们将为您简要呈现该研究团队在新型可吸收骨蜡领域的最新探索与发现：
The clinical efficacy of bone wax critically depends on the host immune response, which is intrinsically linked to the material’s bioabsorbability and degradation mechanisms. To minimize adverse immune reactions, researchers prioritize bioabsorbable materials for designing absorbable bone wax, which are classified into natural polymers, synthetic polymers and bioactive ceramic materials.
骨蜡的临床疗效在很大程度上取决于宿主的免疫反应，而这与材料的生物可吸收性及降解机制密不可分。为了尽可能减少不良免疫反应，研究人员在设计可吸收骨蜡时优先考虑使用生物可降解材料，这些材料主要分为天然聚合物、合成聚合物以及生物活性陶瓷材料三大类。
Natural polymers, such as collagen, fibronectin, starch, and chitosan, undergo in vivo degradation via extracellular enzymatic/oxidative processes and phagocytosis (Fig. 3(I)).Synthetic polymers, including polylactic acid (PLA) and polycaprolactone (PCL), have modifiable components and degradation rates. They are mainly degraded in vivo by hydrolysis, enzymatic degradation and oxidation, involving both surface degradation and bulk degradation modes (Fig. 3(II)).[2] Bioceramics include calcium phosphate, HA and tricalcium phosphate. These materials are mainly dissolved, disintegrated and fragmented into particles by extracellular fluid, and resorption by phagocytosis mediated by macrophages and osteoclasts in vivo (Fig. 3(III)).[3] Table 1 details the component composition, absorbable time, and absorbable mode of various absorbable bone waxes.
胶原蛋白、纤连蛋白、淀粉及壳聚糖等天然聚合物，在体内主要通过细胞外酶解/氧化过程与吞噬作用降解（图1(I)）。合成聚合物如聚乳酸（PLA）和聚己内酯（PCL），其成分与降解速率可调，在体内的降解方式以水解、酶解及氧化作用为主，涵盖表面降解与整体降解两种模式（图1(II)）。生物陶瓷包括磷酸钙、羟基磷灰石（HA）和磷酸三钙，这类材料在体内主要经细胞外液溶解、崩解并碎裂为颗粒，随后通过巨噬细胞与破骨细胞介导的吞噬作用吸收（图1(III)）。表1详细列出了各类可吸收骨蜡的成分组成、吸收时间及吸收模式。
图1 天然聚合物、合成聚合物以及生物活性陶瓷材料体内生物降解的示意图。
(I) 天然聚合物在体内通过细胞外降解和吞噬作用进行降解；
(II) 合成聚合物在体内通过水解、酶解及氧化降解。[2]
(III) 生物陶瓷在体内通过细胞外液溶解和细胞介导的吞噬作用降解。[3]
文章将可吸收骨蜡按照成分划分为三大类：环氧烷烃共聚物类、聚酯类及生物陶瓷水泥类，深入分析了各类材料的吸收性能及其对止血效果、促进骨再生能力和抗菌性能等方面的影响与作用机制，揭示了成分设计与功能表现之间的紧密关联。
Alkylene oxide copolymers are synthesized through the polymerization of ethylene oxide, propylene oxide, or related monomers, exhibiting exceptional water solubility, minimal immunogenicity, and negligible toxicity.[4]Alkylene oxide copolymer-based systems exhibit superior biocompatibility and absorbability compared to traditional bone wax. However, their rapid degradation and insufficient mechanical strength limit their application in situations that require prolonged hemostasis or structural support for bone regeneration.
环氧烷类共聚物由环氧乙烷、环氧丙烷或相关单体经聚合反应合成，具有优异的水溶性、极低的免疫原性及可忽略的毒性。与传统骨蜡相比，基于环氧烷类共聚物的体系展现更优异的生物相容性与可吸收性。然而，该类共聚物存在降解速度过快、机械强度不足的问题，这限制了它们在需要持久止血或为骨再生提供结构支撑等场景中的应用。
Polyester-based absorbable bone wax, exemplified by polylactic acid (PLA) formulations, addresses the limitations of the rapid degradation observed in alkylene oxide systems. PLA-based materials achieve sustained hemostatic effects in clinical settings but face challenges due to acidic byproduct release during hydrolysis, which may induce local inflammation and impair tissue repair.
以聚乳酸（PLA）为代表的聚酯类可吸收骨蜡，克服了环氧烷体系中降解过快的问题。尽管聚乳酸基材料在临床应用中能实现持久的止血效果，但在水解过程中会释放酸性副产物，可能引发局部炎症并阻碍组织修复，因此在应用上面临一定挑战。
Bioceramic cement-based absorbable bone wax is mainly composed of calcium phosphate, calcium sulfate, bioactive glass, and other materials. This type of bone wax balances osteoconductivity and hemostasis but faces challenges in injectability, cost-effectiveness and degradation ratethat match bone healing.
生物陶瓷水泥类可吸收骨蜡主要由磷酸钙、硫酸钙、生物活性玻璃及其他材料组成。这种骨蜡在骨传导性和止血性之间取得了平衡，但在可注射性、成本效益、与骨愈合相匹配的降解速率方面仍面临挑战。
Conventional sterile bone wax effectively achieves hemostasis in osseous defects but carries significant risks due to its non absorbable nature, including foreign body reactions, postoperative infections, and impaired bone regeneration. To address these limitations, modern absorbable bone wax research prioritizes three core functionalities:
(1) rapid hemostatic efficacy, (2) osteogenic capacity to bridge critical-sized defects, and (3) inherent antibacterial properties. These advancements align with the evolving demands of orthopedic and reconstructive surgery.
传统的无菌骨蜡虽然能有效实现骨缺损处的止血，但由于其不可吸收的特性，也带来了显著的风险，包括引发异物反应、术后感染以及阻碍骨组织再生。为了克服这些局限性，新型可吸收骨蜡的研究重点聚焦于三大核心功能：（1）快速止血效能；（2）能够修复临界尺寸骨缺损的成骨性能；（3）抗菌特性。这些技术突破高度契合了骨科和重建外科不断发展的临床需求。
The evolution of bone hemostatic materials has progressed from traditional non-absorbable bone wax to advanced absorbable systems to address biodegradability, inflammation, and bone regeneration challenges. The commercially available products exemplify this progress (Fig. 10), each offering unique advantages tailored to clinical needs.
骨止血材料的演进已经从传统不可吸收骨蜡发展到先进可吸收系统，旨在解决生物降解性、炎症以及骨再生方面的挑战。现有的市售商业化产品正是这一技术进步的缩影（图2，表2），每种产品都提供了针对临床需求的独特优势。
图2 基于环氧烷烃共聚物、聚酯及生物陶瓷骨水泥体系的商业化可吸收骨蜡
The clinical efficacy of bone wax critically depends on the host immune response, which is intrinsically linked to the material’s bioabsorbability and degradation mechanisms. To minimize adverse immune reactions, researchers prioritize bioabsorbable materials for designing absorbable bone wax, which are classified into natural polymers, synthetic polymers and bioactive ceramic materials.
谷泉玉®可吸收骨蜡（供应商：上海鹏冠生物医药科技有限公司）是中国首款获批用于临床应用的产品，该产品由PEG 1500、PEG600和羧甲基纤维素钠组成，在临床表现上展现出卓越性能：
即时止血： 3分钟内实现皮质及松质骨面100%止血率；
生物安全： 2~4周内完全吸收，避免异物残留风险；
促进修复： 具备优异的A级伤口愈合、无炎症、感染风险、不阻碍新骨再生。[6]
这一产品的问世，不仅填补了国产可吸收骨蜡的空白，更在核心性能上实现了对国际同类产品的超越（表2）。
在本文的最后，作者从五个核心维度展望了可吸收骨蜡的未来发展方向：
1. 需精准调控材料的降解动力学，确保其降解速率与自体骨组织再生周期高度匹配；
2. 赋予材料更多功能性(如长效抗菌、成骨诱导及血管生成等)，以应对复杂骨缺损修复需求；
3. 整合医学影像可视化技术，赋予材料显影特性，实现术后的无创动态监测；
4. 拓展材料的临床适应范围，特别是针对脊柱外科等复杂的骨-软组织交界处的止血需求；
5. 建立全面且标准化的评价体系，以加速基础研究向临床应用的转化。
通过在这些前沿领域的深耕，新一代先进可吸收骨蜡有望彻底突破传统止血材料的局限，填补现代骨科与修复重建外科中的关键性技术空白。
[1] LI Z, YANG S, YAN J, et al. Component design and functionalization of absorbable bone wax: from bench to bedside [J]. J Mater Chem B, 2025, 13(44): 14223–38.
[2] LI C, GUO C, FITZPATRICK V, et al. Design of biodegradable, implantable devices towards clinical translation [J]. Nature Reviews Materials, 2020, 5(1): 61–81.
[3] SHEIKH Z, ABDALLAH M-N, HANAFI A A, et al. Mechanisms of in Vivo Degradation and Resorption of Calcium Phosphate Based Biomaterials [J]. Materials, 2015, 8(11): 7913–25.
[4] HERZBERGER J, NIEDERER K, POHLIT H, et al. Polymerization of Ethylene Oxide, Propylene Oxide, and Other Alkylene Oxides: Synthesis, Novel Polymer Architectures, and Bioconjugation [J]. Chemical Reviews, 2016, 116(4): 2170–243.
[5] 朱宏彬, 刘超, 张旭峰. 可吸收骨蜡用于兔胸骨损伤模型的动物实验研究 [J]. 现代医用影像学, 2024, 33(11): 2173–8.
[6] S. P. b. p. center, Absorbable bone wax, https://www.pgbiomed.com.cn/
