ISSN 2149-2263 | E-ISSN 2149-2271
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Volume : 25 Issue : 10 Year : 2021
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Outcomes of intracutaneous sutures in comparison with intracutaneous staples in cardiac implantable-electronic device pocket closure [Anatol J Cardiol]
Anatol J Cardiol. 2021; 25(10): 716-720 | DOI: 10.5152/AnatolJCardiol.2021.96644

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

Jahanzeb Malik1, Nismat Javed2, Ghazanfar Rana3, Muhammad Shoaib4, Uzma Ishaq5, Humaira Chauhan6
1Department of Cardiology, Rawalpindi Institute of Cardiology; Rawalpindi-Pakistan
2Department of Medicine, Shifa College of Medicine; Islamabad-Pakistan
3Department of Cardiology, St. Luke’s General Hospital; Kilkenny-Ireland
4Department of Cardiology, Pakistan Institute of Medical Sciences; Islamabad-Pakistan
5Department of Hematology, Foundation University Medical College; Islamabad-Pakistan
6Department of Medicine, KRL Hospital Kahuta; Kahuta-Pakistan

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.

Keywords: Cardiovascular implantable-electronic devices, pocket pacemaker infection, pacemaker device hematoma, insorb stapler

Jahanzeb Malik, Nismat Javed, Ghazanfar Rana, Muhammad Shoaib, Uzma Ishaq, Humaira Chauhan. Outcomes of intracutaneous sutures in comparison with intracutaneous staples in cardiac implantable-electronic device pocket closure. Anatol J Cardiol. 2021; 25(10): 716-720

Corresponding Author: Jahanzeb Malik, Pakistan