zips study - zip incision approximation vs. suture

Conditions: Wound; Cardiac Arrhythmia

Summary: zipline medical, inc. has developed a novel, non-invasive skin closure device called "zip surgical skin closure" to replace sutures, staples and glue for closure of the skin layer for surgical incisions or laceration repair. the study will be comparing the zip surgical skin closure to standard sutures in patients undergoing cardiovascular implantable electronic device (cied) procedures on outcomes including closure time, cosmetic appearance of resulting scar, and overall cosmetic appearance of scar. the study will be following participants for 3 months following cied procedure.

zipline medical, inc. has developed a novel, non-invasive skin closure device called "zip surgical skin closure" to replace sutures, staples and glue for closure of the skin layer for surgical incisions or laceration repair. the device is designed to provide closure speed superior to sutures, while resulting in a suture-like cosmetic outcome.the zips study is a randomized, clinical trial comparing outcomes of procedures that use the zip surgical skin closure device with the outcomes of procedures that use stitches. the zip surgical skin closure is not an investigational device and is currently used in hospital across the united states. the zip surgical skin closure is a non-invasive (in other words, does not pierce the skin or enter into the wound) device to hold skin closed while healing can occur. it adheres to the skin close to the incision and uses adjustable straps to hold the incision closed. it is typically worn on the skin for 7-14 days and is removed by peeling from the skin. patients will be randomized to either zip surgical skin closure or sutures, in addition to dissolvable sutures for the deeper layers, for surgical procedures for cardiovascular implantable electronic devices (cied) i.e. pacemakers or defibrillators. both of these closure techniques are considered standard of care at this facility and are not themselves experimental. however, the goal of this experimental study is to see if there are any significant differences between the two closure methods, in a controlled study environment. since the zip surgical skin closure device is relatively new to the market, there is a limited amount of information available describing the experience of patients and doctors using the device. in this study, the investigators will be looking to compare the zip surgical skin closure and stitches methods for the time necessary for the surgeon to close the incision, cosmetic appearance of the resulting scar, and satisfaction of you and your surgeon. the investigators will also be monitoring both study groups for occurrence of any adverse (unfavorable) events. patients will be followed for a total of 3 months for this study. all study visits align with standard of care follow up for post-implantation of cied. non-identifiable pictures will be obtained of the scar during follow up and both patients and surgeons will complete questionnaires indicating their experience and satisfaction with the either skin closure method.

Eligibility criteria:
inclusion criteria: 1. patients 18 years of age and older; 2. patients requiring suture closure for epidermal closure (after placement of cardiac implantable electronic devices; including de novo and re implant generator changes); 3. patients willing and able to complete study protocol 4. life expectancy greater than 1 year exclusion criteria: 1. known bleeding disorder not caused by medication; 2. known personal or family history of keloid formation or scar hypertrophy; 3. known allergy or hypersensitivity to non-latex skin adhesives; 4. atrophic skin deemed clinically prone to blistering; 5. any skin disorder affecting wound healing; 6. any other condition that in the opinion of the investigator would make a particular subject unsuitable for this study. 7. pregnancy

Keywords: pacemaker implantable cardioverter defibrillator icd surgical wound closure sutures zipline zips cied cardiovascular implantable electronic devices arrhythmia