B-po02-036 reducing surgical wound pain and bleeding following pacemakers and icd interventions: a new approach for post-surgical wound management

Many patients undergoing ICD and Pacemaker intervention are anticoagulated and it is a common practice to apply a gauze pressure dressing to reduce pocket hematoma and wound bleed. In addition to the surgical wound pain, wound compression increases the pain resulting in narcotics use. We evaluated the pain, comfort levels, and bleeding using a ring made of gel material encapsulated in non stretchable soft plastic to apply uniform compression over the surgical wound and around the device. The wound was covered with Opsite barrier and the gel-ring placed with the device at the center of the ring. Wide elastic tape was used to apply a tight compression of the gel-ring over the wound. The following day wound was examined for hematoma, incisional bleed, pain levels, and point compression pain. The pts. graded the comfort and pain levels 1-10 with 10 being the worse pain. The gel-ring was replaced by gauze compression and the pts. asked to gauge the pain and comfort levels. In 25 patients 14 had pacemakers (PM) implanted, 5 dual-chamber ICD, 4 BiV ICD, and 2 had ICD generator change with pocket revision. Three of the pts. on Warfarin, 17 on NOAC (two also on Plavix), 6 on Plavix and ASA, and 2 on ASA. With the gel-ring the pain level was 2.36±1.6 and 7.12±2 with the gauze (p<0.000), none developed hematoma or wound bleed. With gel-ring compression, 12 pts. did not require any pain meds, 7 Tylenol, 3 Tramadol, and 3 Norco. The Gel-ring remained in place and was easy to apply. After removal, the Gel-rings were sterilized and reused. A Gel-ring compression dressing post PM and ICD implantation is an effective means to reduce pain, prevents pocket and incisional bleeding.