Edward Rojas, Katerina Morgaenko, Louis Brown, Sieu Kim, Sula Mazimba, Rohit Malhotra, Andrew Darby, Oliver Monfredi, Pamela Mason, James Michael Mangrum, David E Haines, Christopher Campbell, Kenneth Bilchick, Nishaki K Mehta
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There were lower MSS scores in the PR group after 2 weeks (p = .03).</p><p><strong>Conclusion: </strong>We have demonstrated the safety of PR application and removal. 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引用次数: 1
摘要
背景:心脏植入式电子装置(CIED)植入术的一个重要并发症是血肿和装置感染的发生。目的:我们旨在评估一种新型机械压迫装置在CIED植入术后预防血肿和美容效果的效果。方法:采用开放、前瞻性、随机、单中心临床试验对植入术患者进行研究。患者随机接受一种新型机械压缩装置(PressRite, PR)或接受设备植入后的标准护理。用校准过的硬度计测量皮肤柔韧性;手术部位由盲法整形外科医生使用曼彻斯特疤痕量表(MSS)和患者与观察者疤痕量表(POSAS)进行评估。通过压力测量、标准化疤痕尺度和耐受性来评估PR的性能。结果:在114例纳入评估的患者中,105例患者符合分析条件。51例患者随机分为管理组(PR)和对照组(54例)。没有患者需要早期切除或经历PR应用的不良反应。血肿11例(对照组14.8%,PR组5.9%,p = NS)。对照组术后手术部位硬度计读数高于PR组(7.50±3.45 vs 5.37±2.78;结论:我们证明了PR应用和去除的安全性。此外,PR似乎可以改善术后皮肤柔韧性,从而促进伤口愈合。
Evaluation of a novel mechanical compression device for hematoma prevention and wound cosmesis after CIED implantation.
Background: An important complication of cardiac implantable electronic devices (CIED) implantation is the development of hematoma and device infection.
Objective: We aimed to evaluate a novel mechanical compression device for hematoma prevention and cosmetic outcomes following CIED implantation.
Methods: An open, prospective, randomized, single-center clinical trial was performed in patients undergoing CIED implantation. Patients were randomized to receive a novel mechanical compression device (PressRite, PR) or to receive the standard of care post device implantation. Skin pliability was measured with a calibrated durometer; the surgical site was evaluated using the Manchester Scar Scale (MSS) by a blinded plastic surgeon and the Patient and Observer Scar Scale (POSAS). Performance of PR was assessed through pressure measurements, standardized scar scales and tolerability.
Results: From the total of 114 patients evaluated for enrollment, 105 patients were eligible for analysis. Fifty-one patients were randomized to management group (PR) and 54 to the control group. No patients required early removal or experienced adverse effects from PR application. There were 11 hematomas (14.8% vs. 5.9% in the control and PR group respectively, p = NS). The control group had higher post procedure durometer readings in the surgical site when compared with the PR group (7.50 ± 3.45 vs. 5.37 ± 2.78; p = < .01). There were lower MSS scores in the PR group after 2 weeks (p = .03).
Conclusion: We have demonstrated the safety of PR application and removal. In addition, PR appears to improve postoperative skin pliability, which could facilitate wound healing.
期刊介绍:
Pacing and Clinical Electrophysiology (PACE) is the foremost peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in its field, featuring original, review, and didactic papers, and case reports related to daily practice. Articles also include editorials, book reviews, Musings on humane topics relevant to medical practice, electrophysiology (EP) rounds, device rounds, and information concerning the quality of devices used in the practice of the specialty.