Full or Half-Thickness Continuous Suture for Right Atrium Incision in Adult Patients Undergoing Open Cardiac Surgery: the Practical Strategy to Reduce Incision Bleeding

Qing-Chun Zhang; Hai-Hui Yin; Jian-An Li; Hong Lei; Jian-Jun Ge

doi:doi:10.11648/j.ass.20180602.14

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Full or Half-Thickness Continuous Suture for Right Atrium Incision in Adult Patients Undergoing Open Cardiac Surgery: the Practical Strategy to Reduce Incision Bleeding

Qing-Chun Zhang, Hai-Hui Yin, Jian-An Li, Hong Lei, Jian-Jun Ge

Published in Advances in Surgical Sciences (Volume 6, Issue 2)

Received: 4 June 2018 Accepted: 27 August 2018 Published: 10 October 2018

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Abstract

Objective The aim of this study was to evaluate the beneficial effects and applicability of a half-thickness continuous suture outside the pectinate muscles used in the right atrial incision for adult patients undergoing cardiac surgery by cardiopulmonary bypass. Methods A total of 1040 consecutive adult patients undergoing cardiac surgery through a right atrium incision during the period of January 2010 to June 2014 were randomly allocated to the experimental group (n=522) and the control group (n=518). In the experimental group, a half-thickness continuous suture outside the pectinate muscles was used to close the right atrium incision, while the traditional method of a continuous full-thickness everting suture was used in the control group. The occurrences of bleeding spots in the right atrium sutures were recorded prior to the pericardial closure procedure. Results The occurrence rates of intra-operative bleeding from the atrial incision site for the experimental group were significantly lower than that in the control group (46 vs. 253 patients needed re-stitch procedures for the right atrial incision respectively, p=0.001). In the control group, two cases of re-exploration due to post-operative bleeding in the right atrial incision occurred, while none occurred in the experimental group. Conclusions The half-thickness continuous suture outside the pectinate muscles for closing right atrium incisions could effectively reduce the need for re-stitch procedures, as well as minimize the risks of bleedings for patients undergoing cardiac surgeries.

Published in	Advances in Surgical Sciences (Volume 6, Issue 2)
DOI	10.11648/j.ass.20180602.14
Page(s)	62-66
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Right Atrium Closure, Pectinate Muscles, Suturing, Bleeding, Cardiac Surgery

References

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[4]	Wu L, Sun ZQ, Jiang XG, Si JW, Xiao YC. Re-exploration for hemorrhage following open heart surgery: 94 cases report. Chin J Clin Thorac Cardiovasc Surg, 2005; 12: 372-373.
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[6]	Okonta K, Rajan S. Re-exploration after open heart surgery at the Madras medical mission, Chennai, India. J West Afr Coll Surg, 2011; 1: 1-17.
[7]	Kirklin JW, Barratt-boys BG. Cardiac Surgery, 2nd edition. New York: Wiley, 1993; p224.
[8]	Grapsa J, Gibbs JS, Cabrita IZ, Watson GF, Pavlopoulos H, Dawson D, et al. The association of clinical outcome with right atrial Eur Heart J Cardiovasc Imaging, 2012; 13:666-672.
[9]	Fukuda Y, Tanaka H, Motoji Y, Ryo K, Sawa T, Imanishi J, et al. Utility of combining assessment of right ventricular function and right atrial remodeling as a prognostic factor for patients with pulmonary hypertension. Int J Cardiovasc Imaging, 2014; 30: 1269-1277.
[10]	Szymański P, Klisiewicz A, Lubiszewska B, Lipczyńska M, Konka M, Kuśmierczyk M, et al. Functional anatomy of tricuspid regurgitation in patients with systemic right ventricles. J Am Soc Echocardiogr, 2010; 23: 504-510.
[11]	Voigt N, Heijman J, Wang Q, Chiang DY, Li N, Karck M, et al. Cellular and molecular mechanisms of atrial arrhythmogenesis in patients with paroxysmal atrial fibrillation. Circulation, 2014; 129:145-156.
[12]	Sergeant P, Kocharian R, Patel B, Pfefferkorn M, Matonick J. Needle-to-suture ratio, as well as suture material, impacts needle-hole bleeding in vascular anastomoses. Interact Cardiovasc Thorac Surg. 2016; 22:813-6.
[13]	Haneya A, Diez C, Kolat P, Suesskind-Schwendi Mv, Ried M, Schmid C, et al. Re-exploration for bleeding or tamponade after cardiac surgery: impact of timing and indication on outcome. Thorac Cardiovasc Surg, 2015; 63:51-57.
[14]	Moulton MJ, Creswell LL, Mackey ME, Cox JL, Rosenbloom M. Re-exploration for bleeding is a risk factor for adverse outcomes after cardiac operations. J Thorac Cardiovasc Surg, 1996; 111:1037-1046.
[15]	Despotis G, Avidan M, Eby C. Prediction and management of bleeding in cardiac surgery. J Thromb Haemost, 2009; 7 Suppl 1:111-117.

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APA Style

Qing-Chun Zhang, Hai-Hui Yin, Jian-An Li, Hong Lei, Jian-Jun Ge. (2018). Full or Half-Thickness Continuous Suture for Right Atrium Incision in Adult Patients Undergoing Open Cardiac Surgery: the Practical Strategy to Reduce Incision Bleeding. Advances in Surgical Sciences, 6(2), 62-66. https://doi.org/10.11648/j.ass.20180602.14

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ACS Style

Qing-Chun Zhang; Hai-Hui Yin; Jian-An Li; Hong Lei; Jian-Jun Ge. Full or Half-Thickness Continuous Suture for Right Atrium Incision in Adult Patients Undergoing Open Cardiac Surgery: the Practical Strategy to Reduce Incision Bleeding. Adv. Surg. Sci. 2018, 6(2), 62-66. doi: 10.11648/j.ass.20180602.14

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AMA Style

Qing-Chun Zhang, Hai-Hui Yin, Jian-An Li, Hong Lei, Jian-Jun Ge. Full or Half-Thickness Continuous Suture for Right Atrium Incision in Adult Patients Undergoing Open Cardiac Surgery: the Practical Strategy to Reduce Incision Bleeding. Adv Surg Sci. 2018;6(2):62-66. doi: 10.11648/j.ass.20180602.14

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@article{10.11648/j.ass.20180602.14,
  author = {Qing-Chun Zhang and Hai-Hui Yin and Jian-An Li and Hong Lei and Jian-Jun Ge},
  title = {Full or Half-Thickness Continuous Suture for Right Atrium Incision in Adult Patients Undergoing Open Cardiac Surgery: the Practical Strategy to Reduce Incision Bleeding},
  journal = {Advances in Surgical Sciences},
  volume = {6},
  number = {2},
  pages = {62-66},
  doi = {10.11648/j.ass.20180602.14},
  url = {https://doi.org/10.11648/j.ass.20180602.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20180602.14},
  abstract = {Objective The aim of this study was to evaluate the beneficial effects and applicability of a half-thickness continuous suture outside the pectinate muscles used in the right atrial incision for adult patients undergoing cardiac surgery by cardiopulmonary bypass. Methods A total of 1040 consecutive adult patients undergoing cardiac surgery through a right atrium incision during the period of January 2010 to June 2014 were randomly allocated to the experimental group (n=522) and the control group (n=518). In the experimental group, a half-thickness continuous suture outside the pectinate muscles was used to close the right atrium incision, while the traditional method of a continuous full-thickness everting suture was used in the control group. The occurrences of bleeding spots in the right atrium sutures were recorded prior to the pericardial closure procedure. Results The occurrence rates of intra-operative bleeding from the atrial incision site for the experimental group were significantly lower than that in the control group (46 vs. 253 patients needed re-stitch procedures for the right atrial incision respectively, p=0.001). In the control group, two cases of re-exploration due to post-operative bleeding in the right atrial incision occurred, while none occurred in the experimental group. Conclusions The half-thickness continuous suture outside the pectinate muscles for closing right atrium incisions could effectively reduce the need for re-stitch procedures, as well as minimize the risks of bleedings for patients undergoing cardiac surgeries.},
 year = {2018}
}

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TY  - JOUR
T1  - Full or Half-Thickness Continuous Suture for Right Atrium Incision in Adult Patients Undergoing Open Cardiac Surgery: the Practical Strategy to Reduce Incision Bleeding
AU  - Qing-Chun Zhang
AU  - Hai-Hui Yin
AU  - Jian-An Li
AU  - Hong Lei
AU  - Jian-Jun Ge
Y1  - 2018/10/10
PY  - 2018
N1  - https://doi.org/10.11648/j.ass.20180602.14
DO  - 10.11648/j.ass.20180602.14
T2  - Advances in Surgical Sciences
JF  - Advances in Surgical Sciences
JO  - Advances in Surgical Sciences
SP  - 62
EP  - 66
PB  - Science Publishing Group
SN  - 2376-6182
UR  - https://doi.org/10.11648/j.ass.20180602.14
AB  - Objective The aim of this study was to evaluate the beneficial effects and applicability of a half-thickness continuous suture outside the pectinate muscles used in the right atrial incision for adult patients undergoing cardiac surgery by cardiopulmonary bypass. Methods A total of 1040 consecutive adult patients undergoing cardiac surgery through a right atrium incision during the period of January 2010 to June 2014 were randomly allocated to the experimental group (n=522) and the control group (n=518). In the experimental group, a half-thickness continuous suture outside the pectinate muscles was used to close the right atrium incision, while the traditional method of a continuous full-thickness everting suture was used in the control group. The occurrences of bleeding spots in the right atrium sutures were recorded prior to the pericardial closure procedure. Results The occurrence rates of intra-operative bleeding from the atrial incision site for the experimental group were significantly lower than that in the control group (46 vs. 253 patients needed re-stitch procedures for the right atrial incision respectively, p=0.001). In the control group, two cases of re-exploration due to post-operative bleeding in the right atrial incision occurred, while none occurred in the experimental group. Conclusions The half-thickness continuous suture outside the pectinate muscles for closing right atrium incisions could effectively reduce the need for re-stitch procedures, as well as minimize the risks of bleedings for patients undergoing cardiac surgeries.
VL  - 6
IS  - 2
ER  -

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Author Information

Qing-Chun Zhang

Department of Cardiac Surgery, the First Affiliated Hospital to University of Science and Technology of China, Hefei, China
Hai-Hui Yin

Department of Cardiac Surgery, the First Affiliated Hospital to University of Science and Technology of China, Hefei, China
Jian-An Li

Department of Cardiac Surgery, the First Affiliated Hospital to University of Science and Technology of China, Hefei, China
Hong Lei

Department of Cardiac Surgery, the First Affiliated Hospital to University of Science and Technology of China, Hefei, China
Jian-Jun Ge

Department of Cardiac Surgery, the First Affiliated Hospital to University of Science and Technology of China, Hefei, China

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APA Style

Qing-Chun Zhang, Hai-Hui Yin, Jian-An Li, Hong Lei, Jian-Jun Ge. (2018). Full or Half-Thickness Continuous Suture for Right Atrium Incision in Adult Patients Undergoing Open Cardiac Surgery: the Practical Strategy to Reduce Incision Bleeding. Advances in Surgical Sciences, 6(2), 62-66. https://doi.org/10.11648/j.ass.20180602.14

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ACS Style

Qing-Chun Zhang; Hai-Hui Yin; Jian-An Li; Hong Lei; Jian-Jun Ge. Full or Half-Thickness Continuous Suture for Right Atrium Incision in Adult Patients Undergoing Open Cardiac Surgery: the Practical Strategy to Reduce Incision Bleeding. Adv. Surg. Sci. 2018, 6(2), 62-66. doi: 10.11648/j.ass.20180602.14

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AMA Style

Qing-Chun Zhang, Hai-Hui Yin, Jian-An Li, Hong Lei, Jian-Jun Ge. Full or Half-Thickness Continuous Suture for Right Atrium Incision in Adult Patients Undergoing Open Cardiac Surgery: the Practical Strategy to Reduce Incision Bleeding. Adv Surg Sci. 2018;6(2):62-66. doi: 10.11648/j.ass.20180602.14

Copy | Download

@article{10.11648/j.ass.20180602.14,
  author = {Qing-Chun Zhang and Hai-Hui Yin and Jian-An Li and Hong Lei and Jian-Jun Ge},
  title = {Full or Half-Thickness Continuous Suture for Right Atrium Incision in Adult Patients Undergoing Open Cardiac Surgery: the Practical Strategy to Reduce Incision Bleeding},
  journal = {Advances in Surgical Sciences},
  volume = {6},
  number = {2},
  pages = {62-66},
  doi = {10.11648/j.ass.20180602.14},
  url = {https://doi.org/10.11648/j.ass.20180602.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20180602.14},
  abstract = {Objective The aim of this study was to evaluate the beneficial effects and applicability of a half-thickness continuous suture outside the pectinate muscles used in the right atrial incision for adult patients undergoing cardiac surgery by cardiopulmonary bypass. Methods A total of 1040 consecutive adult patients undergoing cardiac surgery through a right atrium incision during the period of January 2010 to June 2014 were randomly allocated to the experimental group (n=522) and the control group (n=518). In the experimental group, a half-thickness continuous suture outside the pectinate muscles was used to close the right atrium incision, while the traditional method of a continuous full-thickness everting suture was used in the control group. The occurrences of bleeding spots in the right atrium sutures were recorded prior to the pericardial closure procedure. Results The occurrence rates of intra-operative bleeding from the atrial incision site for the experimental group were significantly lower than that in the control group (46 vs. 253 patients needed re-stitch procedures for the right atrial incision respectively, p=0.001). In the control group, two cases of re-exploration due to post-operative bleeding in the right atrial incision occurred, while none occurred in the experimental group. Conclusions The half-thickness continuous suture outside the pectinate muscles for closing right atrium incisions could effectively reduce the need for re-stitch procedures, as well as minimize the risks of bleedings for patients undergoing cardiac surgeries.},
 year = {2018}
}

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TY  - JOUR
T1  - Full or Half-Thickness Continuous Suture for Right Atrium Incision in Adult Patients Undergoing Open Cardiac Surgery: the Practical Strategy to Reduce Incision Bleeding
AU  - Qing-Chun Zhang
AU  - Hai-Hui Yin
AU  - Jian-An Li
AU  - Hong Lei
AU  - Jian-Jun Ge
Y1  - 2018/10/10
PY  - 2018
N1  - https://doi.org/10.11648/j.ass.20180602.14
DO  - 10.11648/j.ass.20180602.14
T2  - Advances in Surgical Sciences
JF  - Advances in Surgical Sciences
JO  - Advances in Surgical Sciences
SP  - 62
EP  - 66
PB  - Science Publishing Group
SN  - 2376-6182
UR  - https://doi.org/10.11648/j.ass.20180602.14
AB  - Objective The aim of this study was to evaluate the beneficial effects and applicability of a half-thickness continuous suture outside the pectinate muscles used in the right atrial incision for adult patients undergoing cardiac surgery by cardiopulmonary bypass. Methods A total of 1040 consecutive adult patients undergoing cardiac surgery through a right atrium incision during the period of January 2010 to June 2014 were randomly allocated to the experimental group (n=522) and the control group (n=518). In the experimental group, a half-thickness continuous suture outside the pectinate muscles was used to close the right atrium incision, while the traditional method of a continuous full-thickness everting suture was used in the control group. The occurrences of bleeding spots in the right atrium sutures were recorded prior to the pericardial closure procedure. Results The occurrence rates of intra-operative bleeding from the atrial incision site for the experimental group were significantly lower than that in the control group (46 vs. 253 patients needed re-stitch procedures for the right atrial incision respectively, p=0.001). In the control group, two cases of re-exploration due to post-operative bleeding in the right atrial incision occurred, while none occurred in the experimental group. Conclusions The half-thickness continuous suture outside the pectinate muscles for closing right atrium incisions could effectively reduce the need for re-stitch procedures, as well as minimize the risks of bleedings for patients undergoing cardiac surgeries.
VL  - 6
IS  - 2
ER  -

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