title: The Neurostimulation Appropriateness Consensus Committee (NACC) Recommendations for Infection Prevention and Management.
abstract: BACKGROUND
  The use of neurostimulation for pain has been an established therapy for many decades and is a major tool in the arsenal to treat neuropathic pain syndromes. Level I evidence has recently been presented to substantiate the therapy, but this is balanced against the risk of complications of an interventional technique.
  
  
  METHODS
  The Neurostimulation Appropriateness Consensus Committee (NACC) of the International Neuromodulation Society convened an international panel of well published and diverse physicians to examine the best practices for infection mitigation and management in patients undergoing neurostimulation. The NACC recommendations are based on evidence scoring and peer-reviewed literature. Where evidence is lacking the panel added expert opinion to establish recommendations.
  
  
  RESULTS
  The NACC has made recommendations to improve care by reducing infection and managing this complication when it occurs. These evidence-based recommendations should be considered best practices in the clinical implantation of neurostimulation devices.
  
  
  CONCLUSIONS
  Adhering to established standards can improve patient care and reduce the morbidity and mortality of infectious complications in patients receiving neurostimulation.
authors.affiliation: Center for Pain Relief, Charleston, WV, USA.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Deer
authors.affiliation: Pain Diagnostics and Interventional Care, Sewickley, PA, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Provenzano
authors.affiliation: Jacksonville Spine Center, Jacksonville, FL, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Hanes
authors.affiliation: Summit Pain Alliance, Santa Rosa, CA, USA.
authors.forename: Jason E
authors.initials: JE
authors.lastname: Pope
authors.affiliation: Pain Management and Neuromodulation Centre, Basildon & Thurrock University Hospitals, NHS, Trust, UK.
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Thomson
authors.affiliation: Hunter Pain Clinic, Broadmeadow, NSW, Australia.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Russo
authors.affiliation: Pain Doctor, Inc, Phoenix, AZ, USA.
authors.forename: Tory
authors.initials: T
authors.lastname: McJunkin
authors.affiliation: MossRehab, Elkins Park, PA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Saulino
authors.affiliation: Florida Pain, Jupiter, FL, USA.
authors.forename: Louis J
authors.initials: LJ
authors.lastname: Raso
authors.affiliation: Division of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
authors.forename: Shivanand P
authors.initials: SP
authors.lastname: Lad
authors.affiliation: Summa Western Reserve Hospital, Cuyahoga Falls, OH, USA.
authors.forename: Samer
authors.initials: S
authors.lastname: Narouze
authors.affiliation: St. Luke's University Health Network, Bethlehem, PA, USA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Falowski
authors.affiliation: Marcus Neuroscience Institute, Boca Raton, FL, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Levy
authors.affiliation: Leeds Teaching Hospital, NHS Trust, Leeds, UK.
authors.forename: Ganesan
authors.initials: G
authors.lastname: Baranidharan
authors.affiliation: Florida Pain Melbourne Clinic, Melbourne, FL, USA.
authors.forename: Stanley
authors.initials: S
authors.lastname: Golovac
authors.affiliation: Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
authors.forename: Didier
authors.initials: D
authors.lastname: Demesmin
authors.affiliation: Cardinal Hill Pain Institute (emeritus), Lexington, KY, USA.
authors.forename: William O
authors.initials: WO
authors.lastname: Witt
authors.affiliation: Department of Neurosurgery, University Hospital of Wales, Cardiff, UK.
authors.forename: Brian
authors.initials: B
authors.lastname: Simpson
authors.affiliation: Pacific Pain Treatment Center (ret.), San Francisco, CA, USA.
authors.forename: Elliot
authors.initials: E
authors.lastname: Krames
authors.affiliation: Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Nagy
authors.initials: N
authors.lastname: Mekhail
mesh_terms: D004599:Electric Stimulation Therapy / Q000009:adverse effects*; D006801:Humans; D017053:Infection Control / Q000379:methods / Q000592:standards*; D007239:Infections; D009437:Neuralgia / Q000628:therapy; D017410:Practice Guidelines as Topic; D011367:Professional Staff Committees / Q000592:standards*
keywords: Complications; neuromodulation; perioperative medicine; recommendations; risk reduction; spinal cord stimulation; surgical site infection