Abstract
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 Jan 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, 2 with impending erosion, and one with a chronic sinus. Patients 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 post-procedure. The followup 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. This article is protected by copyright. All rights reserved.
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