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Published on: May 26, 2023
Vacuum-assisted wound closure for pacemaker infection.
1Department of Cardiovascular Surgery, Kishiwada City Hospital, Osaka, Japan. t-satsu@lilac.tky.plala.or.jp
Pacing and Clinical Electrophysiology : PACE
|December 23, 2009
Summary
Vacuum-assisted wound closure (VAC) effectively treats infected permanent pacemakers, avoiding extensive surgery. This less-invasive approach offers a viable option for pacemaker infections, particularly when system explantation poses high risks.
Area of Science:
- Cardiology
- Infectious Diseases
- Wound Management
Background:
- Infection is a significant complication following pacemaker implantation.
- Optimal treatment strategies for pacemaker system infections remain undefined.
- This study explores a less-invasive treatment for infected pacemakers.
Observation:
- Patients presented with local inflammation and purulent collections in pacemaker pockets.
- Treatment involved fenestration of pacemaker pockets followed by vacuum-assisted wound closure (VAC).
- Patients included a man in his 60s, an octogenarian, and two nonagenarian females.
Findings:
- Infection was eradicated in all patients without aggressive surgical intervention.
- Two patients underwent wound re-suture without complete pacemaker system removal.
- Two patients had infected generator removal, with wounds healing with or without re-suture; mean VAC duration was 19.5 days.
Implications:
- Vacuum-assisted wound closure (VAC) presents a less-invasive alternative for treating infected pacemakers.
- This method is particularly beneficial when the risk of total system explantation is high.
- Patients remained asymptomatic with no recurrent infection for 5-15 months post-discharge.
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