Use of MPH hemostatic powder for electrophysiology device implantation reduces postoperative rates of pocket hematoma and infection
| Autor: | Philippe Akhrass, Joseph Bastawrose, Olga Reynbakh, Pierre Boktor, Emad Aziz, Joshua E Aziz, Davendra Mehta, Hasnun Nahar, Nektarios Souvaliotis, Chaithanya K Pamidimukala |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Prosthesis-Related Infections HEMOSTATIC POWDER 030204 cardiovascular system & hematology Postoperative Hemorrhage Hemostatics Prosthesis Implantation 03 medical and health sciences 0302 clinical medicine Hematoma Surgical site Medicine Humans Surgical Wound Infection 030212 general & internal medicine Aged Retrospective Studies Hemostatic Agent business.industry Starch General Medicine Middle Aged medicine.disease United States Surgery Defibrillators Implantable Electrophysiology Outcome and Process Assessment Health Care Female business |
| Zdroj: | Current medical research and opinion. 34(10) |
| ISSN: | 1473-4877 |
| Popis: | Surgical site bleeding and infection are potential complications after electrophysiology (EP) device implantation procedures. To date, there is a wide variety of tools for management of intraoperative bleeding but it still remains unclear what methods are preferred.The aim of our study is to compare the rate of complications in patients who underwent cardiac implantable electronic device (CIED) implantation utilizing MPH hemostatic powder to the rate of complications in those patients who underwent standard procedure protocol without MPH hemostatic powder.In our study, a new plant-derived microporous polysaccharide hemostatic powder (Arista) was used. A total of 283 consecutive patients were retrospectively studied to assess the rate of complications in patients who underwent CIED implantation with MPH hemostatic powder (n = 77, MPH hemostatic powder) and without (n = 206, no MPH hemostatic powder). Patients were followed for 12 months.The MPH hemostatic powder group of patients had a lower complication rate when compared to no MPH hemostatic powder, 0.3% vs. 1.7% (p .05), respectively. The rate of device implantation site MPH hematoma in the MPH hemostatic powder group was 0.4%, versus 0.9% in the other group. There were no postoperative infections in the MPH hemostatic powder group versus 3.2% infections in the other group. The main predictor of increased risk of post-procedural complication was the usage of anticoagulation with a hazard ration of 2.7.Using MPH hemostatic powder for post-procedural hemostasis was shown to result in a significant reduction in the rate of overall post-procedural complications (a composite endpoint of hematoma and infections), and a trend in reduction of the infections rates and device implantation site hematoma rates. |
| Databáze: | OpenAIRE |
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