The value and limitations of a wound inspection clinic after cardiac device implantation.
BACKGROUND
Due to the growing number of cardiac device implantations it is important to develop methods to reduce device-implantation related complications.


OBJECTIVE
To determine whether a wound inspection clinic can play a role in the detection of device-implantation related complications.


METHODS
Single-center observational study evaluating patients who received a pacemaker or implantable cardioverter-defibrillator (ICD).


RESULTS
Of 159 patients who received an appointment for the wound inspection clinic, 52 (33%) received a pacemaker and 107 (67%) received an ICD. The majority had no signs of infection. Pain (n = 13,8%) and swelling (n = 11,7%) were the most frequent signs observed, but they never necessitated intervention and recovered spontaneously in all patients. During follow-up (mean 20+/-9 weeks), complications occurred in 10 patients (6%). Most complications occurred early, within 4 days after implantation. The two late complications (at 19 and 41 days) could not be recognized at the wound inspection clinic.


CONCLUSIONS
We found no useful role for a wound inspection clinic two weeks post-implant to detect device-related complications. Open rapid access to the pacemaker/ICD center for patients with signs and symptoms of (threatening) complications seems to be more appropriate to manage post-implant patients.
Deuling
J Han H
JH
Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Smit
Marcelle D
MD
Maass
Alexander H
AH
Van den Heuvel
Ad F M
AF
Nieuwland
Wybe
W
Zijlstra
Felix
F
Van Gelder
Isabelle C
IC
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000601:surgery / Q000628:therapy*; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners; D010044:Outpatient Clinics, Hospital; D010138:Pacemaker, Artificial; D013527:Perioperative Nursing / Q000379:methods*; D013530:Surgical Wound Infection / Q000451:nursing / Q000517:prevention & control*