Average Pressure Application over the Post-Cardiac Device Implantation Site with Conventional Pressure Dressing Technique

Background: Wound healing for a cardiac device implantation is a complex process, prompting doctors to shift their focus on the prevention of hematomas that could eventually lead to bacterial infection. The current practice incorporates anticoagulation interruption and application of pressure dressing over the post-cardiac device implantation site. Pressure application has potential to reduce hematomas and risk of device infection. Objective: Testing of conventional pressure dressing technique was done on 3 volunteers by 1 trained operator to assess how much pressure is applied. A Kikuhime (MediTrade, Soro, Denmark) sub-bandage pressure measuring device covered in gauze sponges (Covidien, Dublin, Ireland) was placed on left and right upper chest area of the volunteers, and Tensoplast (BSN medical, Hamburg, Germany) was used to apply pressure. Method: Pressure readings were taken 6 times at 5-minute intervals for 30 minute session, repeated 3 times. Average pressure applied was 3.32-7.64 mmHg; for left side 3.71-10.14 mmHg; for right side 2.93 to 5.14 mmHg. The average central venous pressure in healthy adults is 8-12 mmHg, with pressures vary depending on factors like hydration or heart failure. The medical assessment of quality of life before the pressure tests averaged at 1 for both sides and after the pressure tests averaged at 2.37 for both sides. Conclusion: The current standard is unreliable with minimal pressure applied over the site, therefore the validity of this procedure is questionable. Limitations of this method include lack of wound visualization and discomfort associated with pressure dressings.