Summary of the best evidence for the prevention and management of pocket hematoma in patients with cardiovascular implantable electronic devices

WU Yanqing; JIN Ting; LIN Shulan; WANG Yingying; LIN Bixia

doi:10.12104/j.issn.1674-4748.2026.05.007

Abstract：Objective:To summarize the relevant evidence on the prevention and management of pocket hematoma in patients with cardiovascular implantable electronic devices(CIED)at home and abroad,and lay an evidence-based foundation for clinical practice.Methods:PIPOST framework was used to construct evidence-based questions,computer searches were conducted in databases and websites such as National Institute for Health and Care Excellence,Scottish Intercollegiate Guidelines Network,BMJ Best Practice,the Joanna Briggs Institute(JB I)Evidence-Based Healthcare Center Database,UpToDate,the Cochrane Library,PubMed,and CNKI to retrieve literature related to the prevention and management of pocket hematoma in patients with CIED.The types of literature included clinical decisions,practice guidelines,evidence summaries,specialist consensus,and systematic reviews.The search period ranged from the establishment of the databases to March 22,2025.Two researchers trained in evidence-based nursing independently assessed the quality of the included researches,extracted data and integrated evidence.Results:A total of 23 articles were ultimately included,comprising 1 practice guideline,1 evidence summary,6 specialist consensus and 15 systematic reviews.The evidence was summarized into 22 recommendations across five aspects,anticoagulation management,pocket wound management,posture management,activity management of the surgical limb,and continuity of care.Conclusion:This study has collated the relevant evidence on the prevention and management of pouch hematoma in CIED patients.It suggests that healthcare providers should combine with the clinical situation and the patient's wishes to formulate scientific and standardized measures for the prevention and management of pouch hematoma in CIED patients,thereby reducing the occurrence of such hematomas.