Hemostatic efficacy of a novel Ca/P/S-based bone graft material and its preliminary clinical evidence in sternum closure procedures.

Median sternotomy is the standard approach for cardiac surgery. Still, it is often complicated by excessive marrow bleeding and impaired healing, particularly in frail patients, and conventional hemostatic agents can control bleeding but frequently compromise bone regeneration. We evaluated Ezechbone® Granule CBS-400, a fully synthetic Ca/P/S-based bone graft substitute, against commercially available calcium-based products to address this challenge. In vitro blood clotting assays showed that CBS-400 consistently achieved the lowest blood clotting index, indicating rapid clot formation. In vivo rat tibial implantation revealed denser and more stable fibrin fiber networks and markedly reduced white blood cell infiltration, highlighting superior clot stability and early biocompatibility compared with controls. Clinical pilot applications in high-risk sternotomy patients confirmed its translational relevance: CBS-400 reduced chest tube drainage, shortened drainage duration, and decreased intensive care unit stays while supporting stable sternal healing. These findings demonstrate that CBS-400 combines hemostatic efficacy with osteoregenerative potential, positioning it as a multifunctional biomaterial that may improve outcomes in complex surgical settings. Larger randomized studies are warranted to validate these results and define optimal clinical use.