Adherent skin barrier drape use is associated with a reduced risk of cardiac implantable device infection: Results from a prospective study of 14,225 procedures

被引：0

作者：

Golian, Mehrdad ^{[1
,2
,5
]}

Berbenetz, Nicolas M. ^{[1
,2
]}

Odabashian, Roupen ^{[1
,2
]}

Sadek, Mouhannad M. ^{[1
,2
]}

Corrales-Medina, Vicente ^{[3
,4
]}

Aydin, Alper ^{[1
,2
]}

Davis, Darryl R. ^{[1
,2
]}

Green, Martin S. ^{[1
,2
]}

Klein, Andres ^{[1
,2
]}

Nair, Girish M. ^{[1
,2
]}

Nery, Pablo B. ^{[1
,2
]}

Ramirez, Daniel ^{[1
,2
]}

Redpath, Calum ^{[1
,2
]}

Hansom, Simon P. ^{[1
,2
]}

Birnie, David H. ^{[1
,2
]}

机构：

[1] Univ Ottawa Heart Inst, Ottawa, ON, Canada

[2] Univ Ottawa, Dept Med, Div Cardiol, Ottawa, ON, Canada

[3] Univ Ottawa, Dept Med, Div Infect Dis, Ottawa, ON, Canada

[4] Ottawa Hosp, Ottawa, ON, Canada

[5] Univ Ottawa Heart Inst, H-1285D,40 Ruskin St, Ottawa, ON K1Y 4W7, Canada

来源：

HEART RHYTHM | 2024年 / 5卷 / 02期

关键词：

Infection; Antibiotics; Pacemaker; Implantable cardi- overter-defibrillator; Cardiac implantable electronic device; Pulse generator change; Device upgrade; Complication; PREVENTION; TRIAL; DEFIBRILLATORS; MANAGEMENT; PACEMAKERS; SOCIETY; DISEASE; SURGERY;

D O I：

10.1016/j.hroo.2023.12.002

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Cardiac implantable electronic device (CIED) infection is a costly and highly morbid complication. Perioperative interventions, including the use of antibiotic pouches and intensified perioperative antibiotic regimens, have demonstrated marginal efficacy at reducing CIED infection. Additional research is needed to identify additional interventions to reduce infection risk. OBJECTIVE We sought to evaluate whether adherent skin barrier drape use is associated with a reduction in CIED infection. METHODS A prospective registry of all CIED implantation procedures was established at our institution in January 2007. The registry was established in collaboration with our hospital infection prevention team with a specific focus on prospectively identifying all potential CIED infections. All potential CIED infections were independently adjudicated by 2 physicians blinded to the use of an adherent skin barrier drape. RESULTS Over a 13 -year period, 14,225 procedures were completed (mean age 72 6 14 years; female 4,918 (35%); new implants 10,005 (70%); pulse generator changes 2585 (18%); upgrades 1635 (11%). Of those, 2469 procedures (17.4%) were performed using an adherent skin barrier drape. There were 103 adjudicated device infections (0.73%). The infection rate in patients in the barrier use groups was 8 of 2469 (0.32%) as compared with 95 of 11,756 (0.8%) in the nonuse group (P = .0084). In multivariable analysis, the use of an adherent skin barrier drape was independently associated with a reduction in infection (odds ratio 0.32; 95% confidence interval 0.154-0.665; P = .002). CONCLUSION The use of an adherent skin barrier drape at the time of cardiac device surgery is associated with a lower risk of subsequent infection.

引用

页码：103 / 112

页数：10