Authors (including presenting author) :
Wong NL
Affiliation :
Coronary Care Unit, United Christian Hospital
Keyword 1: :
Single-piece postoperative dressing
Keyword 2: :
ICD and conventional PPM implantation dressing
Keyword 3: :
Enhance patient outcomes
Keyword 4: :
Cost-effectiveness
Keyword 5: :
Process efficiency
Keyword 6: :
Staff satisfaction
Introduction :
Implantable Cardioverter Defibrillator (ICD) and Conventional Permanent Pacemaker (PPM) implantation procedures require effective postoperative wound management to prevent infection, promote wound healing, and ensure patient comfort. The current practice in the Cardiac Catheterization and Intervention Centre (CCIC) employs a multi-piece external dressing system for postoperative ICD and conventional PPM wounds. This approach may impair wound breathability, prolong procedure time, and increase resource utilization. Transitioning to a single-piece dressing system offers an opportunity to streamline application, enhance efficiency, improve cost-effectiveness and enhance staff satisfaction while maintaining or improving patient outcomes.
Objectives :
(1) To maintain or enhance early postoperative wound outcomes. (2) To enhance procedure efficiency by streamlining dressing application. (3) To improve cost effectiveness by reducing dressing material cost. (4) To enhance cardiologists, nurses, and PCAs’ satisfaction.
Methodology :
(1) Select a new single-piece advanced dressing proven suitable for ICD and conventional PPM wounds based on available evidence and product characteristics. (2) Perform cost-analysis. (3) Conduct a prospective trial of the new dressing in 30 consecutive patients undergoing de-novo or replacement implantation of an ICD or conventional PPM in the CCIC. (4) Historical baseline data were collected retrospectively from the 30 most recent consecutive patients who underwent de novo or replacement implantation of an ICD or conventional PPM with the traditional multi-piece dressing; Outcome measures were categorized into patient wound outcomes, which were retrieved from the CMS with specific review of cardiac nursing documentation recorded at the postoperative day 10–17 follow-up visit, and staff satisfaction survey.
Result & Outcome :
Results: From September to December 2025, 30 patients were served with the new dressing. Dressing-related complications showed equivalent or superior performance, with infection, dressing displacement, allergy, maceration, and patient-reported discomfort occurring at zero incidence in both groups. Skin blistering was completely eliminated in the intervention group (from 3.3% to 0%). Reassuringly, no escalation in implant-site complications was observed. On the contrary, notable reductions occurred in wound dehiscence (from 23.3% to 6.7%) and oozing (from 6.7% to 0%), alongside favourable trends toward reduced bruising (from 46.7% to 36.7%) and swelling (from 20% to 16.7%). Cost per patient was reduced by 45.8% (from HKD 13.38 to HKD 7.25), with projected annual savings of HKD 1,226 for ~200 cases. Post-implementation feedback (100% response rate) showed that 100% of cardiologists (n=6) agreed on simplicity, ease of application, and reduced time. Only one neutral response was recorded for “better appearance” and “more appropriate size”, with the remainder in full agreement. Over 90% of nurses and PCAs (n=21) agreed on better appearance and quicker preparation, while over 85% agreed on a more appropriate size, with remaining responses neutral. Overall, 100% preferred permanent adoption. Conclusion: OPSITE Post-Op meets all project objectives for improved efficiency, cost-effectiveness, staff acceptance, and patient outcomes without compromising safety. Permanent adoption as the standard post-operative dressing for ICD and conventional PPM implantation is strongly recommended, with ongoing monitoring in future PDCA cycles.
