Abstract 16204: The Use of a Novel Suture Material in Cardiac Device Implantation

Abstract

Background: Cardiac implantable electric device (CIED) implantation is a minor surgical procedure. One post-surgery complication often experienced is a suture knot projecting out of the skin 1-3 months after surgery. A unidirectional barbed suture (V-Loc; Covidien, Mansfield, MA) is a suture with barbs, which enables securing sutures without knots. The conventional sutures often leave a knot protruding at the suture line end; however, V-Loc eliminates the need to tie surgical knots and leaves a clean surface. Objective: We aimed to evaluate the safety and efficacy of V-Loc use in CIED implantation. Methods: A total of 153 patients underwent CIED implantation. Eighty-one patients were sutured using conventional string (PDS; Ethicon, Somerville, NJ) and V-Loc was used in 72 cases. A conventional method is to close a wound in three layers. After approximating the subcutaneous tissue in two layers with 3/0 PDS, the skin was closed with 4/0 PDS. Meanwhile, the new technique involves an over-and-over running stitch on the subcutaneous tissue with 3/0 V-Loc, followed by skin closure with 4/0 V-Loc. Results: The average suturing time was shorter in the V-Loc group than in the conventional group (9.9±1.7 vs. 18.0±4.1 mins. P<0.01). This translated to a reduction in closure time by 45% (8.1 mins) without complications such as wound infection and dehiscence. In the conventional group, 16 of 81 patients (19.8%) had a suture knot projecting out without infection. Conclusion: V-loc suture material offers the possibility of a knotless stitch. We noted positive results in patients who were sutured with V-loc, and suggest its usefulness in CIED implantation.