Low-budget, single-session elimination of CIED pocket infection
| Autor: | Hisham Samir Roshdy, Radwa Abdullah Elbelbesy, Elshaimaa Seaoud |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Pacemaker Artificial Prosthesis-Related Infections 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Recurrence Gas plasma Medicine Humans In patient 030212 general & internal medicine Povidone-Iodine Ultrasonic irrigation business.industry General Medicine Hydrogen Peroxide Middle Aged Surgery Anti-Bacterial Agents Anti-Infective Agents Local Female Cardiology and Cardiovascular Medicine business Single session |
| Zdroj: | Pacing and clinical electrophysiology : PACEREFERENCES. 44(1) |
| ISSN: | 1540-8159 |
| Popis: | Background The dramatic increase in the use of cardiovascular implantable electronic devices (CIED) was associated with an increased rate of CIED infection, which has a high management cost. Aim of the study To test the safety and efficacy of a single-session protocol, aiming to reuse the infected pocket side and the same device and leads in patients with CIED pocket infection. Patients and methods We included patients with isolated pocket infection between January 2015 and November 2019. The Patient was prepared by taking a swab for culture and sensitivity before the procedure. The pocket was debrided and the capsule was removed, the pocket was rinsed with povidone-iodine and hydrogen peroxide mixture, then packed with gauze sponge soaked with povidone-iodine. The device was debrided using ultrasonic irrigation and sterilized using gas plasma. The device was reimplanted and the wound was closed in layers. Results During the period of the study, we had 12 patients with isolated pocket infection. Nine presented with erosion, two with impending erosion, and one with a chronic sinus. Patient's age was 61.5 ± 7.64 years. The infection was diagnosed 14.2 ± 8.22 weeks post device implantation. They were admitted for 7.6 ± 1.54 days postprocedure. The follow-up duration was 26.5 ± 15 (1.7-52) months. Only one patient (8%) had a recurrence of the infection after 50 days of the procedure. Conclusion Our protocol was successful in treating 92% of device-related pocket infection without the need to replace the device or the pocket side. |
| Databáze: | OpenAIRE |
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