Novel Compression Tool to Prevent Hematomas and Skin Erosions After Device Implantation

Kiuchi, Kunihiko; Okajima, Katsunori; Tanaka, Naoko; Yamamoto, Yoko; Sakai, Nobuyuki; Kanda, Gaku; Shimane, Akira; Yokoi, Kohei; Teranishi, Jin; Aoki, Kousuke; Chimura, Misato; Kono, Shingo; Takahashi, Yuu; Matsuyama, Sonoko; Tsubata, Hideo; Miyata, Toshio; Matsuoka, Yuki; Toba, Takayoshi; S, Ohishi; Sawada, Takahiro; Tsukishiro, Yasue; Onishi, Tetsuari; Kobayashi, Seiichi; Moriya, Fumie; Takai, Hiromi; Yamada, Shinichiro; Taniguchi, Yoshinori; Yasaka, Yoshinori; Kawai, Hiroya

doi:10.1253/circj.cj-15-0341

Cited by 8 publications

(9 citation statements)

References 17 publications

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“…31 There is also a small, randomized controlled trial testing the use of a newly designed pressure bandage that does not utilize tape with direct skin contact, which has shown modest positive results for the prevention of hematoma and skin erosion. 32 PPB did not decrease hematoma rates in our patient cohort. It was associated with an odds increase of 1.53 in the H analysis and a decrease of 0.67 in the CSH analysis, both nonsignificant.…”

Section: Ppb and Operator Factorscontrasting

confidence: 45%

“…Apart from pressure bandaging, this includes meticulous cautery and irrigation of the pocket to remove debris . There is also a small, randomized controlled trial testing the use of a newly designed pressure bandage that does not utilize tape with direct skin contact, which has shown modest positive results for the prevention of hematoma and skin erosion …”

Section: Discussionmentioning

confidence: 99%

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Cardiac implantable electronic device hematomas: Risk factors and effect of prophylactic pressure bandaging

Koh

Bingham

Law

et al. 2017

Pacing Clinical Electrophis

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Section: Ppb and Operator Factorscontrasting

confidence: 45%

Section: Discussionmentioning

confidence: 99%

Cardiac implantable electronic device hematomas: Risk factors and effect of prophylactic pressure bandaging

Koh

Bingham

Law

et al. 2017

Pacing Clinical Electrophis

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“…The secondary outcomes were skin erosions and patient comfort scores. Skin erosions were defined as skin damage observed during the removal of the adhesive tape or dressing ( 17 ). The comfort level of the patients was assessed on a visual analog scale (VAS) during the application of a sandbag or compression.…”

Section: Methodsmentioning

confidence: 99%

Effect of a Novel Pocket Compression Device on Hematomas Following Cardiac Electronic Device Implantation in Patients Receiving Direct Oral Anticoagulants

Fei

Wang

Zhu

et al. 2022

Front. Cardiovasc. Med.

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BackgroundA pocket hematoma is a well-recognized complication that occurs after pacemaker or defibrillator implantation. It is associated with increased pocket infection and hospital stay. Patients suffering from atrial fibrillation and undergoing cardiovascular electronic implantable device (CIED) surgery are widely prescribed and treated with direct oral anticoagulants (DOACs). In this study, the use of a novel compression device was evaluated to examine its ability to decrease the incidence of pocket hematomas following device implantation with uninterrupted DOACs.MethodsA total of 204 participants who received DOACs and underwent CIED implantation were randomized into an experimental group (novel compression device) and a control group (elastic adhesive tape with a sandbag). The primary outcome was pocket hematoma, and the secondary outcomes were skin erosions and patient comfort score. Grade 3 hematoma was defined as a hematoma that required anticoagulation therapy interruption, re-operation, or prolonged hospital stay.ResultsThe baseline characteristics of both groups had no significant differences. The incidence of grades 1 and 2 hematomas was significantly lower in the compression device group than in the conventional pressure dressing group (7.8 vs. 23.5 and 2.0 vs. 5.9%, respectively; P < 0.01). Grade 3 hematoma occurred in 2 of 102 patients in the experimental group and 7 of 102 patients in the control group (2.0 vs. 6.9%; P = 0.03). The incidence rates of skin erosion were significantly lower, and the patient comfort score was much higher in the compression device group than in the control group (P < 0.01). Multivariable logistic regression analysis showed that the use of novel compression device was a significant protective factor for pocket hematoma (OR = 0.42; 95% CI, 0.29–0.69, P = 0.01).ConclusionsThe incidence of pocket hematomas and skin erosions significantly decreases when the proposed compression device is used for patients undergoing device implantation with uninterrupted DOACs. Thus, the length of hospital stay and re-operation rate can be reduced, and patient comfort can be improved.Clinical Trial Registrationhttp://www.chictr.org.cn, identifier: ChiCTR2100049430.

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“…3,4 The implantation of the pulse generator in a subcutaneous pectoral pocket is another weakness of conventional TV systems, because of complications with pain, limitation of shoulder motion, hematoma, erosion, infection and cosmetic dissatisfaction. 5,6 It is particularly noteworthy that an infection of the pacing system often requires its total extraction. 7 Leadless transcatheter pacing (TCP) was conceived over 40 years ago, in the hope of eliminating the complications associated with TV leads, but was initially impractical.…”

Section: Editorialmentioning

confidence: 99%

Miniaturized Leadless Cardiac Pacemakers　― Can They Overcome the Problems With Transvenous Pacing Systems? ―

Oginosawa

Kohno

Ohe

et al. 2017

Circ J

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vulnerable component of conventional systems. In the perioperative period, the creation of a pneumothorax is a relatively common complication of the subclavian vein puncture needed to introduce the leads into the cardiac C ardiac pacemakers are among the most successful implantable medical devices and the only treatment for bradyarrhythmias. Despite remarkable progress achieved in the function, longevity and physical characteristics since the first implantation of a pacing system in 1958, several aspects of conventional pacing remain unresolved. The transvenous (TV) leads, in particular, remain the most Article p 1589 The opinions expressed in this article are not necessarily those of the editors or of the Japanese Circulation Society.

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Novel Compression Tool to Prevent Hematomas and Skin Erosions After Device Implantation

Cited by 8 publications

References 17 publications

Cardiac implantable electronic device hematomas: Risk factors and effect of prophylactic pressure bandaging

Cardiac implantable electronic device hematomas: Risk factors and effect of prophylactic pressure bandaging

Effect of a Novel Pocket Compression Device on Hematomas Following Cardiac Electronic Device Implantation in Patients Receiving Direct Oral Anticoagulants

Miniaturized Leadless Cardiac Pacemakers　― Can They Overcome the Problems With Transvenous Pacing Systems? ―

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Novel Compression Tool to Prevent Hematomas and Skin Erosions After Device Implantation

Cited by 8 publications

References 17 publications

Cardiac implantable electronic device hematomas: Risk factors and effect of prophylactic pressure bandaging

Cardiac implantable electronic device hematomas: Risk factors and effect of prophylactic pressure bandaging

Effect of a Novel Pocket Compression Device on Hematomas Following Cardiac Electronic Device Implantation in Patients Receiving Direct Oral Anticoagulants

Miniaturized Leadless Cardiac Pacemakers ― Can They Overcome the Problems With Transvenous Pacing Systems? ―

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Miniaturized Leadless Cardiac Pacemakers　― Can They Overcome the Problems With Transvenous Pacing Systems? ―