Dermatologic Surgery Pearls: Bonewax-Assisted Second Intention Healing

Dr. Karen Connolly, a dermatologic surgeon at Memorial Sloan Kettering Center, presented on the use of bone wax in secondary intention healing during dermatologic surgery. Traditionally employed in orthopedic settings, bone wax is a sterile, inexpensive product consisting mainly of wax and softening agents, which can facilitate healing in dermal wounds—especially in concave areas such as the ear and scalp. Dr. Connolly highlighted its advantages, including its non-adherent nature, ability to be molded into various shapes, and waterproof properties, allowing patients to maintain hygiene without disturbing the healing wound. She noted its effectiveness for various complex wounds, including nail injuries and scalp defects, and provided several case examples demonstrating successful results. Although some concerns about increased infection rates exist in orthopedic literature, she emphasized that her dermatologic use does not encounter such issues. Ultimately, bone wax offers a low-maintenance, cost-effective dressing option that fosters a favorable healing environment while improving patient comfort.