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Negative-pressure wound therapy (NPWT) for the treatment of pacemaker pocket infection in patients unable or unwilling to undergo CIED extraction

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

The occurrence of cardiac pacemaker pocket infection has markedly increased and has become a new problem facing cardiovascular internists. The aim of our study was to investigate the effectiveness and safety of treating cardiac pacemaker pocket infection using negative-pressure wound therapy (NPWT) in patients who are unwilling or unable to have their cardiac implantable electronic devices (CIEDs) removed.

Methods

From March 2013 to April 2019, NPWT was applied to 26 patients with cardiac pacemaker pocket infection who were unwilling or unable to have their CIEDs removed. In the first stage, a negative-pressure drainage system was placed in the pacemaker pocket after debridement. Then, NPWT was used to seal the wound, and the negative pressure (300–400 mmHg) was sustained for 5–7 days. In the second stage, the pacemaker was relocated to the subpectoral layer, and the wound was closed.

Results

In all but three of our 26 patients, the wound healed completely without complications and without evidence of residual infection. The average follow-up period was 26.92 ± 9.46 months. Only 3 diabetic patients whose tissue bacterial cultures revealed that methicillin-resistant Staphylococcus epidermidis developed uncontrolled infections. Eventually, the entire original pacemaker systems were removed, and new pacemakers were implanted in the contralateral chest wall.

Conclusions

When warranted by strictly selected indications, the method of NPWT without CIED extraction can be considered as a new and effective treatment for patients with pacemaker pocket infection who are unwilling or unable to have the device removed.

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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

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Author notes

  1. Shengwu Zheng and Xiongmei Huang contributed equally to this work.

Authors and Affiliations

  1. Department of Burn and Plastic Surgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, No. 134, Street East, Fuzhou, 350001, China

    Shengwu Zheng, Xiongmei Huang, Genhui Lin & Jing Zhuang

  2. Department of Cardiology, Fujian Heart Disease Research Institute, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China

    Yazhou Lin

  3. Department of Anesthesiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China

    Xiaohui Chen

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  1. Shengwu Zheng
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Contributions

Conceptualization: Shengwu Zheng and Xiongmei Huang; methodology: Shengwu Zheng; formal analysis and investigation: Yazhou Lin, Xiaohui Chen, Genhui Lin, and Jing Zhuang; writing–original draft preparation: Xiongmei Huang; writing–review and editing: Shengwu Zheng and Xiaohui Chen; resources: Shengwu Zheng and Xiongmei Huang; supervision: Shengwu Zheng.

Corresponding author

Correspondence to Shengwu Zheng.

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The authors declare that they have no conflict of interest.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Fujian Provincial Hospital (No. K2013-02-002).

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Informed consent was obtained from the patients prior to study participation.

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This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Zheng, S., Huang, X., Lin, Y. et al. Negative-pressure wound therapy (NPWT) for the treatment of pacemaker pocket infection in patients unable or unwilling to undergo CIED extraction. J Interv Card Electrophysiol 61, 245–251 (2021). https://doi.org/10.1007/s10840-020-00805-y

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  • DOI: https://doi.org/10.1007/s10840-020-00805-y

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