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The Anatolian Journal of Cardiology Outcomes of Intracutaneous Sutures in Comparison to Intracutaneous Staples in Cardiac Implantable Electronic Device Pocket Closure [Anatol J Cardiol]
Anatol J Cardiol. Ahead of Print: AJC-96644

Outcomes of Intracutaneous Sutures in Comparison to Intracutaneous Staples in Cardiac Implantable Electronic Device Pocket Closure

Jahanzeb Malik1, Nismat Javed3, Ghazanfar Rana2, Muhammad Shoaib4, Uzma Ishaq6, Humaira Chauhan5
1Department of Cardiology, Rawalpindi Institute of Cardiology
2Department of Cardiology, Saint Luke's General Hospital
3Department of Medicine, Shifa College of Medicine
4Department of Cardiology, Pakistan Institute of Medical Sciences
5Department of Medicine, KRL Hospital
6Department of Pathology, Foundation University Medical College

Background
With the increase in cardiovascular implantable-electronic devices (CIED), the complications
from insertion and healing are also increasing. Therefore, the objective of the 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 3 months on patients with CIED. Data were collected regarding patient characteristics and adverse events. The
endpoints were 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 months’ observation 27 patients (22.6%) in Group 1 and 13 patients (12.1%) in Group 2 suffered from early adverse events and the combined primary endpoint was reached significantly (0.02). Minor and
major bleeding events were more common in Group 1 (Risk: 4.49, P=0.02; Risk: 0.96, P=0.05).
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



Corresponding Author: Jahanzeb Malik, Pakistan