Conducting Dermatological Operations in Patients Who Have Previously Undergone Cardiac Surgery

Argen Nabievich Irmatov,Diana Taymazovna Amirchupanova,Pavel Vladimirovich Nasonov,Ravan Seyfeddin Ogly Shukyurli,Rukizhat Gasbulakhovna Kurbanmagomedov,Vitaly V Goncharov

doi:10.9734/jpri/2021/v33i29b31606

Abstract

Thoracic surgical procedures and the use of cardiac devices such as pacemakers are becoming increasingly common in the population. Therefore, dermatologists may be more likely to encounter previously implanted or discarded surgical material during a dermatological operation on the chest wall. A basic understanding of the types of wires and tunneling paths used in such procedures is essential to accurately predict the presence of these wires and effectively manage any chance encounters. Dermatologists should be aware that temporary epicardial pacemaker electrodes and pacemaker electrodes often remain in the chest wall of many patients. All patients with a history of cardiac surgery should be asked about the possible presence of temporary epicardial electrodes in their body, and if such materials are found during the operation, it is necessary to immediately stop the procedure and do not undertake further manipulations with them until the material from which it is made is determined. Specialists in cardiology and cardiothoracic surgery need to document any abandoned wire in the patient's list of problems and inform the patient about the abandoned wire so that he or she can be an important source of clinical information. Trying to pull out the remaining pacemaker electrodes is a serious risk, so dermatologist surgeons should not attempt it under any circumstances. When detecting wire material, it is necessary to determine the type and location of the material before any manipulation or pulling attempts. Once it is established that this is a non-functional, abandoned wire, it is necessary to apply the correct technique for removing it, which consists in gently pulling and securing the wire at the exit point. Accurate identification of the material is required in order not to interfere with the operation of the active device and not to abandon the operation unnecessarily. The aim of the work is to consider the implementation of dermatological operations in patients who have previously undergone cardiac surgery.

Highlights

Conducting dermatological operations is associated with a number of problems that arise for various reasons
The aim of the work is to consider the implementation of dermatological operations in patients who have previously undergone cardiac surgery
A 77-year-old man complained of an increasing mass on the right neck near the lower attachment of the sternocleidomastoid muscle, identified as a hematoma caused by a migrating fragment of sternal wire, 6 years after the aortic valve was repaired

Summary

Introduction

Conducting dermatological operations is associated with a number of problems that arise for various reasons. As cardiac surgery becomes more common due to an aging population and new advances in the diagnosis and treatment of heart disease, dermatologists and dermatological surgeons encounter many patients with a history of cardiac surgery. These patients may have had implanted cardiac devices, such as pacemakers and implantable cardioverter defibrillators (ICDs) [1]. The literature describes the possible complications that may occur and the precautions that must be taken when performing dermatological surgery with the simultaneous use of electrosurgery in these patients. There is very little data on the problems that may arise when maintaining temporary cardiology equipment [2]

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