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Late infections of pacemaker units due to silicone rubber insulation boots
Abstract:
Early in 1980, there was an increase at our hospital of late infections of pulse generator pockets not due to perforation. No source of contamination could be found; then, late in 1981, the infection rate decreased. The only change in procedure during this period was the introduction of silicone rubber boots around the pacemaker unit to prevent muscle pacing. The risk of late infection was 13.8%, when using a rubber boot, while otherwise it was only 2.6% (p less than 0.001). The infections were usually caused by ordinary skin bacteria. The authors believe that the infections were due to bacteria introduced inside the rubber boot, where they were practically out of reach of the ordinary defense mechanisms. The decrease in infection rate occurred after the introduction of silicone-coated pacemakers.
Insights
Silicone rubber boots around pacemaker units increased late infection risk by 13.8% compared to 2.6% without them. This suggests bacteria trapped within the boots caused these infections.
Area of Science:
- Cardiology
- Infectious Diseases
- Biomaterials Science
Background:
- An increase in late pulse generator pocket infections was observed.
- No source of contamination was identified during the initial period.
Purpose of the Study:
- To investigate the cause of increased late pulse generator pocket infections.
- To evaluate the role of silicone rubber boots in these infections.
Main Methods:
- A retrospective analysis of infection rates before and after the introduction of silicone rubber boots.
- Comparison of infection rates between patients with and without silicone rubber boots.
Main Results:
- The late infection rate was significantly higher (13.8%) when silicone rubber boots were used, compared to when they were not (2.6%).
- Infections were commonly caused by skin bacteria, suggesting localized contamination.
- The infection rate decreased after the introduction of silicone-coated pacemakers.
Conclusions:
- Silicone rubber boots may create a protected environment for bacterial growth, increasing the risk of late pacemaker pocket infections.
- Further research is needed to understand the mechanism of infection associated with these devices.
- The findings suggest a need for revised surgical techniques or device designs to mitigate infection risk.