title: Therapy of cardiac device pocket infections with vacuum-assisted wound closure-long-term follow-up.
abstract: BACKGROUND
  Cardiac device infections are serious complications that require aggressive treatment strategies, including interventional or surgical lead extraction.
  
  
  METHODS
  Here we describe the long-time follow-up of vacuum-assisted closure (V.A.C.) treatment in five patients with local cardiac device infection (LDI). In these patients the device was removed, the electrodes were shortened, and a V.A.C. treatment was applied. The primary endpoint was defined as time to re-LDI.
  
  
  RESULTS
  Three patients had LDI of a pacemaker pocket, whereas two presented with an infection of their ICD pocket. The V.A.C. treatment was applied for 34.4 ± 17.9 days. The mean hospitalization time was 38.6 ± 19.2 days. The follow-up period was assessed for 34.6 ± 19.2 months. Only one patient developed re-LDI, 69 days after removal of the device. The other four patients did not show any signs of reinfection during the follow-up period. None of the five patients sustained serious adverse events.
  
  
  CONCLUSIONS
  V.A.C. treatment may be an option for selected patients with LDI who refuse a laser-guided lead extraction or surgical removal of the electrodes as the primary therapy.
authors: Department for Cardiology and Angiology Charité University Hospital, Berlin, Germany. wolfram.poller@charite.de
authors: Wolfram C
authors: WC
authors: Poller
authors: Marius
authors: M
authors: Schwerg
authors: Christoph
authors: C
authors: Melzer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003646:Debridement; D017147:Defibrillators, Implantable / Q000382:microbiology*; D006801:Humans; D007902:Length of Stay; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D054843:Negative-Pressure Wound Therapy; D010138:Pacemaker, Artificial / Q000382:microbiology*; D012008:Recurrence; D013203:Staphylococcal Infections / Q000628:therapy; D013530:Surgical Wound Infection / Q000628:therapy*; D016896:Treatment Outcome; D014945:Wound Healing