Reuse of internal pulse generator in cases of infection after deep brain stimulation surgery.
BACKGROUND
Hardware-related infection after deep brain stimulation (DBS) is one of the most serious complications and may need additional interventions.


OBJECTIVE
To reuse the internal pulse generator (IPG) after DBS infection and to reduce the economic costs.


METHODS
A database of 102 patients who underwent DBS surgery was used in the study. The incidence, clinical characteristics and management of infections while reusing the IPG after DBS-related infection were analyzed and reported.


RESULTS
The overall infection rate was 5.9% (6 of 102 patients). Management consisted of total hardware removal followed by intravenous antibiotics. The IPG was at first kept in a solution, then rinsed with water and dried following sterilization with ethylene oxide gas at 38 °C for 18 h. When the treatment of the infection was finished, we reused the IPG and reimplanted the DBS. No hardware-related infection or other complications were observed after reimplantation.


CONCLUSIONS
Management of hardware-related infections can be challenging. The medical and economic costs associated with these infections are enormous. The IPG can often be saved in infected patients. Thus, a significant cost burden is eliminated. Properly executed, reuse of IPG should markedly reduce the costs of these devices.
Department of Neurosurgery, Pamukkale University, Denizli, Turkey.
Selcuk
S
Gocmen
Ozkan
O
Celiker
Abdullah
A
Topcu
Aikaterini
A
Panteli
Goksemin
G
Acar
Feridun
F
Acar
D000368:Aged; D046690:Deep Brain Stimulation / Q000009:adverse effects / Q000295:instrumentation*; D004567:Electrodes, Implanted / Q000009:adverse effects / Q000382:microbiology*; D004866:Equipment Contamination / Q000517:prevention & control; D017743:Equipment Reuse / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000175:diagnosis / Q000628:therapy*; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000209:etiology*