The Neurostimulation Appropriateness Consensus Committee (NACC) Recommendations for Infection Prevention and Management

The Neuromodulation Appropriateness Consensus Committee on Best Practices for Dorsal Root Ganglion Stimulation

“…A similar process was used to create the first neurostimulation guidelines published in 2014 by the Neurostimulation Appropriateness Consensus Committee (NACC). These are living documents, subject to revision based upon new literature and changes in practice; as such, both the NACC and PACC documents have been regularly updated. This consensus guideline for DRG stimulation adds to the NACC family of guidance manuscripts and for the first time incorporates a systematic literature review.…”

“…Recent guidelines have established SCS as a safe and cost‐effective treatment that helps improve function and decrease pain . Despite the overall success of SCS in treating many neuropathic pain conditions, focal pain conditions such as complex regional pain syndrome (CRPS), phantom limb pain, and injury or disease of the peripheral nervous system have created challenges to SCS efficacy.…”

International Continence Society best practice statement for use of sacral neuromodulation

“…The choice to close the wound primarily or allow it to heal by secondary intention should be decided on a case by case basis. Other techniques to combat infection can be considered …”

“…Two separate studies have shown that MRI studies of the extremities other than the head and body MRI scanning including the lumbar spine and pelvis can be performed safely with earlier and current InterStim devices. Elkelini as well as Chermanski reported the results from individual small series of patients studied without event using the interstim I device, using 1.5 and 0.6 Tesla machines. In one case, a generator (IPG) was found to be damaged after study due to leaving the magnet switch on, and both studies recommended setting the amplitude to zero and turning the magnet switch off.…”

The Neurostimulation Appropriateness Consensus Committee (NACC) Safety Guidelines for the Reduction of Severe Neurological Injury

“…The NACC recommends that its previously published guidelines be followed for the prevention of SSI related to SCS implants (see Table ). If a deep tissue infection occurs, the device should be explanted and appropriate tissue and fluid bacterial cultures and antibiotic sensitivities should be obtained.…”