Outcomes of intracutaneous sutures in comparison with intracutaneous staples in cardiac implantable-electronic device pocket closure

Abstract

Objective: With the increase in cardiovascular implantable-electronic devices (CIEDs), complications from insertion and healing are also increasing. Therefore, the objective of this study was to compare the intracutaneous stapling method to the absorbable suture technique in terms of complications, procedure time, and pocket closure time. Methods: An observational study was conducted over the course of three months on patients with CIED implantation. The patients were divided in two groups according to pocket closure technique. Group 1 included patients with pocket closure using intracutaneous sutures; whereas in Group 2, the pocket was closed by intracutaneous staples. Data were collected regarding patient characteristics and wound problems. The endpoints were wound problems, including early and late wound problems (primary), total procedure time, and the time taken for pocket closure (secondary). Results: One hundred and nineteen patients and 107 patients were allocated to Group 1 and Group 2, respectively. During the three-month observation period, 27 (22.6%) patients in Group 1 and 13 (12.1%) patients in Group 2 suffered from early wound problems, and the combined primary endpoint reached was statistically significant (p=0.021). Minor and major bleeding events were more common in Group 1 [Odds ratio (OR): 4.49, p=0.024; OR: 0.96, p=0.052]. The time to close the pocket was markedly reduced in Group 2 (7.29±1.42 vs. 3.98±1.19, p<0.001). Conclusion:The rate of early wound problems is higher using intracutaneous sutures; and therefore, intracutaneous staples should be preferred to prevent these problems.

Measures to Prevent Infection in Cardiac Implantable Electronic Device Replacements or Upgrades

“…Besides sutures, alternative methods like staples, skin closure devices, and adhesives have been evaluated in patients who are undergoing CIED implantation [ 52 , 53 , 54 , 55 ]. While these studies consistently report similar outcomes, their limitations lie in their single-center and observational nature, as well as their small sample sizes.…”

Nanotechnology in interventional cardiology: A state-of-the-art review

“…Since the first pacemaker insertion in 1958 by Dr. Senning, there have been major developments in CIED technology, including a reduction in size, battery extension, remote monitoring capacity, as well as MRI-compatibility [77] . Despite advancements, conventional CIEDs have inherent limitations and a potential for complications due to the creation of surgical pockets and placement of epicardial or transvenous leads [78] . These complications often lead to a considerable increase in morbidity, mortality, and healthcare expenditure [79] .…”