Bundled preparation of skin antisepsis decreases the risk of cardiac implantable electronic device-related infection

Abstract

Pocket haematoma was the most important risk factor for CIED infection. The bundled skin antiseptic preparation strategy significantly reduced the risk of minor CIED infection.

Prevention of Cardiac Implantable Electronic Device Infections: Single Operator Technique with Use of Povidone‐Iodine, Double Gloving, Meticulous Aseptic/Antiseptic Measures and Antibiotic Prophylaxis

“…The latter measure was adopted after the results of a study suggesting a role of the preaxillary flora in device infections . A similar approach for skin antiseptic preparation has been suggested by other investigators …”

“…9 A similar approach for skin antiseptic preparation has been suggested by other investigators. 10 The price for being so meticulous to ensure absence or complete treatment of preexisting infection may be a delay in performing the CIED implant procedure calling for the need for prolonged hospitalization and/or the need for utilizing a temporary pacemaker for certain patients with its attendant potential adverse consequences. However, even then, when this is done in an appropriate way, one can save the patient the risk of the disastrous consequences of device infection conferred by a smoldering or incompletely treated infectious source.…”

Bundled skin antiseptic preparation for complex cardiac implantable electronic device infection: a propensity-score matching cohort study

“…Of note, our previous study revealed that, in comparison with the standard skin antiseptic preparation, a bundled skin antiseptic preparation reduces CIED infection risk in the general population undergoing CIED implantation [11]. Nowadays, we face a general population with a higher prevalence of comorbidities, and more complex procedures, both of which increase CIED infection risk [2,3,9,11]. Therefore, the purpose of this prospective observational study was to test the hypothesis that a bundled skin antiseptic preparation in complex CIED procedures would reduce the CIED infection risk to as low as that in non-complex CIED procedures.…”

“…However, an effective skin antiseptic strategy has not been established [3,6,10]. Of note, our previous study revealed that, in comparison with the standard skin antiseptic preparation, a bundled skin antiseptic preparation reduces CIED infection risk in the general population undergoing CIED implantation [11]. Nowadays, we face a general population with a higher prevalence of comorbidities, and more complex procedures, both of which increase CIED infection risk [2,3,9,11].…”

<div>Review of cardiac implantable electronic device related infection</div>

“…For example, the "bundled skin antiseptic preparation" showed superiority compared to standard sterilization techniques, but it requires more time and more resources. 51 Good hemostasis throughout the procedure is also beneficial as the risk of hematoma formation will be reduced, and consequently the risk of infection. 30 In contrast, other sterilization techniques have been associated with increased risk of infection.…”