Gentamicin beads in vascular surgery: long-term results of implantation

Benaerts, P. J.; Ridler, B. M. F.; Vercaeren, P. M. K.; Thompson, John F.; Wb, Campbell

doi:10.1016/s0967-2109(99)00015-0

Cited by 29 publications

(26 citation statements)

References 4 publications

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“…Reported infection clearance rates range from 60% to 100% with recurrence rates between 0% and 20%. [15][16][17][18][19] Our previous study using antibiotic beads for left ventricular assist device (LVAD) salvage, where the infected LVAD device remained in the infected pocket by necessity, demonstrated pocket sterilization (>2 consecutive negative fluid cultures) in 65.4% of cases with a recurrence rate of 17.6%. 20 In this study where the breast prosthesis was exchanged, our pocket sterilization rate was 100%.…”

Section: Antibiotic-impregnated Pmma Implantsmentioning

confidence: 99%

One-Step Salvage of Infected Prosthetic Breast Reconstructions Using Antibiotic-Impregnated Polymethylmethacrylate Plates and Concurrent Tissue Expander Exchange

Albright

Xue

McKnight

et al. 2016

Annals of Plastic Surgery

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Section: Antibiotic-impregnated Pmma Implantsmentioning

confidence: 99%

One-Step Salvage of Infected Prosthetic Breast Reconstructions Using Antibiotic-Impregnated Polymethylmethacrylate Plates and Concurrent Tissue Expander Exchange

Albright

Xue

McKnight

et al. 2016

Annals of Plastic Surgery

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“…Other substances bonded to Dacron grafts and shown to reduce the incidence of prosthetic graft infection in animal studies include polycationic peptides [7], liposome-encapsulated amikacin [8], and levofloxacin [9]. Gentamicin beads have been implanted in patients, either temporarily or permanently, for either treatment or prophylaxis of patients at high risk [10].…”

Section: Prevention Of Graft Infectionmentioning

confidence: 99%

New Alternatives in Management of the Infected Vascular Prosthesis

Wilson

2001

Surgical Infections

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Advances in the management of infected vascular prostheses over the last decade have led to improved mortality and decreased amputation rates with conventional excision and extraanatomical bypass. Newer methods including in situ graft replacement with antibiotic-impregnated prosthetics appear suitable for low-virulence S. epidermidis infection. Early results are promising for cryopreserved allografts and autogenous femoral vein in situ grafts; however, more clinical experience and longer follow-up will be needed to confirm their durability in a contaminated field.

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“…15,[20][21][22][23][24][25] If patients are pacemaker dependent, a temporary pacer is placed at or before the time of exchange. 15,23 Reimplantation of devices, if necessary, depends on the location of the infection.…”

Section: Pacemakersmentioning

confidence: 99%

“…5 Antibiotic-impregnated beads have been successfully used in the treatment of prosthetic-related infections by orthopedic and vascular surgeons with reported clearance rates ranging from 60% to 100% with recurrence rates ranging from 0 to 20%. 22,[27][28][29][30][31] The beads are capable of delivering high concentrations of necessary antibiotics directly to a site of infection, thereby reducing the systemic side effects. Beads are available in resorbable and nonresorbable materials.…”

Section: Left Ventricular Assist Device Salvagementioning

confidence: 99%

Treatment of Infected Cardiac Implantable Electronic Devices

Fakhro

Jalalabadi

Brown

et al. 2016

Seminars in Plastic Surgery

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Since their earliest application, cardiac implantable electronic devices (CIEDs), such as pacemakers, implantable defibrillators, and left ventricular assist devices (LVADs), have proven beneficial in the prevention of fatal cardiac-related disorders. 1 The past 50 years have seen a sharp rise in cardiac implantable device use with a resultant decline in deaths from ischemic, myocardial, and cardiac rhythm causes. 2 As the indications and guidelines governing CIED use broaden, so too does their widespread employment. 3 The rate of CIED infections has mirrored their increased use with some studies suggesting that the rate of device infections has overshadowed their implantation rate. 4 Infections pose a severe burden on patients, lead to significant health care costs and lengthy hospital stays, and may also lead to mortality. 5 When compared with noninfectious cardiac device complications, pacemaker infections result in an 8.4-to 11.6-fold increase in mortality rates along with a mean hospitalization cost ranging from $31,149 to $55,003. 6 Although both pacemakers and LVADs are implantable cardiac devices, their infection profile and treatment differ significantly due to the size of the device and the need for an external power source for the LVAD. However, both demonstrate a wide range of infection rates, with the true incidence of infection remaining elusive. 7 Topkara et al report a pacemaker infection rate of between 13% and 80%; however, others estimate it to be between 2% and 4% with rates rising 124% between years 1990 to 1999 and a 57% rise from 2004 to 2006, respectively. 8,9 Similarly, infection rates related to LVAD placement demonstrate a large range of between 13% and 80% among recipients. 10 This wide variability in infection risk is in part due to different types of infections that have been included under the category of CIED-related infections. Various reports broadly included patients with surgical site infections, postoperative pneumonia, central venous catheter-related sepsis, and nosocomial urinary tract infections, in addition to infection of the CIED. 10 Various comorbidities may contribute to CIED infections. Patients of advanced age, with congestive heart failure, with a metastatic malignancy, on corticosteroid therapy, or with renal failure are more likely to develop CIED infections thereby increasing their mortality. 9 Device Infection Diagnosis PacemakersThe diagnosis of pacemaker infections is often challenging. Pocket site infections are diagnosed clinically, often presenting with inflammatory skin changes including pain, swelling, AbstractWith their rising benefits, cardiac implantable electronic devices (CIEDs) such as pacemakers and left ventricular assist devices (LVADs) have witnessed a sharp rise in use over the past 50 years. As indications for use broaden, so too does their widespread employment with its attendant rise of CIED infections. Such large numbers of infections have inspired various algorithms mandating treatment. Early diagnosis of inciting organisms is crucial to...

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Gentamicin beads in vascular surgery: long-term results of implantation

Cited by 29 publications

References 4 publications

One-Step Salvage of Infected Prosthetic Breast Reconstructions Using Antibiotic-Impregnated Polymethylmethacrylate Plates and Concurrent Tissue Expander Exchange

One-Step Salvage of Infected Prosthetic Breast Reconstructions Using Antibiotic-Impregnated Polymethylmethacrylate Plates and Concurrent Tissue Expander Exchange

New Alternatives in Management of the Infected Vascular Prosthesis

Treatment of Infected Cardiac Implantable Electronic Devices

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