Low budget, single session elimination of CIED pocket infection

Faculty Medicine Year: 2020
Type of Publication: ZU Hosted Pages:
Authors:
Journal: PACE Wiley Volume:
Keywords : , budget, single session elimination , CIED pocket    
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.
   
     
 
       

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