Stapling for wound dehiscence after cardiac implantable electronic device implantation
| Autor: | Asif Sewani, Peyton Card, Ozan Paydak, Fuad Habash, Naga Venkata Pothineni |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Pacemaker Artificial lcsh:Internal medicine lcsh:Diseases of the circulatory (Cardiovascular) system medicine.medical_treatment Post-Procedure lcsh:Medicine device infection wound dehiscence wound stapling Single Center Surgical Stapling Surgical Wound Dehiscence medicine Humans lcsh:RC31-1245 Aged Retrospective Studies Chemotherapy Wound dehiscence business.industry lcsh:R Retrospective cohort study Middle Aged medicine.disease Implantable cardioverter-defibrillator Icd implantation Surgery Defibrillators Implantable lcsh:RC666-701 Female device implantation Cardiology and Cardiovascular Medicine Complication business |
| Zdroj: | Türk Kardiyoloji Derneği Arşivi, Vol 46, Iss 4, Pp 242-247 (2018) |
| ISSN: | 1016-5169 |
| Popis: | Objective Wound dehiscence (WD) has been reported as a complication in 0.3% of cardiac implantable electronic device (CIED) procedures. Stapling has not previously been reported as a treatment modality for WD. Presently described is the experience of a single center with WD and its management. Methods A retrospective chart review of all patients who underwent CIED implantation between 2009 and 2016, a total of 759 devices, was performed. Results There were a total of 11 (1.4%) patients with WD. The majority 9/11 patients were female, 5 of 11 (45.5%) had diabetes, and 2 of the 11 patients were immunocompromised due to recent chemotherapy. WD occurred in 6 patients after generator change, in 2 patients after a biventricular device upgrade, in 1 patient after biventricular implantable cardioverter defibrillator (ICD) implantation, in 1 patient after dual-chamber pacemaker implantation, and in 1 patient after subcutaneous ICD implantation. The median time of WD was 6 weeks post procedure (range: 1-20 weeks). In all of the patients, wound stapling was performed under sterile conditions after administering intravenous narcotic analgesics. Eight patients received intravenous antibiotics and all patients received at least 2 weeks of oral antibiotics. Blood cultures were negative in 8/11 (72.7%) patients. However, the wound cultures in 5 patients were positive. The staples were removed in a median of 16 days (range: 9-36 days). All of these patients were successfully treated with stapling and none of the devices required extraction. Conclusion Stapling under sterile conditions may be an acceptable treatment strategy to manage WD after device implantation. This can be performed as an outpatient procedure and can help avoid unnecessary device extraction. |
| Databáze: | OpenAIRE |
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