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

摘要

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.