Nismat Javed1, Jahanzeb Malik2,

1Shifa College of Medicine, Islamabad, Pakistan, 2Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan

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 absorbable suture techniques in terms of complications, procedure time, and pocket closure time.

Method(s):
An observational study was conducted over the course of 3 months on patients with CIED after splitting them into two groups for intracutaneous suture (Group 1) and intracutaneous absorbable stapling (Group 2). 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). The data were analyzed using IBM SPSS.

Result(s):
One hundred and nineteen patients and 107 patients were allocated to Group 1 and Group 2 respectively. Early endpoints were reached more often with the suture group compared with the staple group (26.00% vs. 13.00%, P=0.03). The details are mentioned in Table 1. Minor and major bleeding events were more common in Group 1 (Risk: 4.49, P=0.02; Risk: 0.96, P=0.05). Explantation was more common in Group 1 as compared with Group 2 (12.60% vs. 5.60%). The time to close the pocket was markedly reduced in Group 2 (7.29 ± 1.42 vs. 3.98 ± 1.19, P<0.001). These details are mentioned in Table 2.

Conclusion(s):
The rate of early wound problems is higher using intracutaneous sutures and therefore, intracutaneous suturing should be preferred to prevent these problems.