New Treatment for Driveline Infection Following Implantation of a Ventricular Assist Device

Sezai, Akira; Unosawa, Satoshi; Taoka, Makoto; Osaka, Shunji; Kitazumi, Yoshiki; Suzuki, Keito; Nakai, Toshiko; Tanaka, Masashi

doi:10.1532/hsf.2899

Cited by 6 publications

(4 citation statements)

References 9 publications

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“…They have also used this ointment for disinfection immediately after implantation to prevent DLI in 6 patients with an extracorporeal left VAD (duration 4-240 days) and in 1 patient with the HMII, and none of these patients experienced infection. 115 It has been reported that allogeneic platelet gel (PLT-gel) 118 and platelet-rich plasma (PRP) 119 were effective in the treatment of DLIs. PLT-gels and PRP contain high a concentration of platelet-derived growth factors, transforming growth factor-β1, and vascular endothelial growth factor which enhances activity of fibroblasts, mesenchymal cells, and stromal cells in the process of wound healing.…”

Section: Treatmentmentioning

confidence: 99%

“…They have also used this ointment for disinfection immediately after implantation to prevent DLI in 6 patients with an extracorporeal left VAD (duration 4–240 days) and in 1 patient with the HMII, and none of these patients experienced infection. 115…”

Section: Management Of Dli—diagnostic Workup and Treatmentmentioning

confidence: 99%

“…This method seems potentially useful in identifying areas of high bacterial load and in the assessment of debridement extent. 114 Sezai et al 115 reported their experience of using methylrosanilinium chloride (crystal violet or pioktanin) mixed with Solbase (macrogol) in an ointment. Methylrosanilinium chloride is well known as a blue pigment for Gram staining and is also used as an antimicrobial and antiparasitic agent.…”

Section: Treatmentmentioning

confidence: 99%

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Ventricular Assist Device Driveline Infections: A Systematic Review

Krželj

Petričević

Gašparović

et al. 2021

Thorac Cardiovasc Surg

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Infection is the most common complication in patients undergoing ventricular assist device (VAD) implantation. Driveline exit site (DLES) infection is the most frequent VAD infection and is a significant cause of adverse events in VAD patients, contributing to morbidity, even mortality, and repetitive hospital readmissions. There are many risk factors for driveline infection (DLI) including younger age, smaller constitution of patients, obesity, exposed velour at the DLES, longer duration of device support, lower cardiac index, higher heart failure score, DLES trauma, and comorbidities such as diabetes mellitus, chronic kidney disease, and depression. The incidence of DLI depends also on the device type. Numerous measures to prevent DLI currently exist. Some of them are proven, whereas the others remain controversial. Current recommendations on DLES care and DLI management are predominantly based on expert consensus and clinical experience of the certain centers. However, careful and uniform DLES care including obligatory driveline immobilization, previously prepared sterile dressing change kits, and continuous patient education are probably crucial for prevention of DLI. Diagnosis and treatment of DLI are often challenging because of certain immunological alterations in VAD patients and microbial biofilm formation on the driveline surface areas. Although there are many conservative and surgical methods described in the DLI treatment, the only possible permanent solution for DLI resolution in VAD patients is heart transplantation. This systematic review brings a comprehensive synthesis of recent data on the prevention, diagnostic workup, and conservative and surgical management of DLI in VAD patients.

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Section: Treatmentmentioning

confidence: 99%

Section: Management Of Dli—diagnostic Workup and Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Ventricular Assist Device Driveline Infections: A Systematic Review

Krželj

Petričević

Gašparović

et al. 2021

Thorac Cardiovasc Surg

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“…Equally critical is the practice of meticulous wound care protocols that are well adjusted to the needs of the different stages of DLIs. The progression of DLIs and the characteristics of percutaneous wounds are strong determinants of the selected therapeutic protocol, that can involve wound dressing in combination with supplementary treatments, such as negative pressure vacuum-assisted closure therapy, cold atmospheric plasma, and antibiotic beads (Bernhardt et al 2020 ; Haddad et al 2020 ; Hilker et al 2017 ; Kilo et al 2020 ; Sezai et al 2020 ). In many cases however, the therapeutic benefits are decapacitated by relapsing infections related to biofilm persistence.…”

Section: Clinical Protocols Against Driveline Infections (Dlis)mentioning

confidence: 99%

Systems of conductive skin for power transfer in clinical applications

Kourouklis

Kaemmel

et al. 2021

Eur Biophys J

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The primary aim of this article is to review the clinical challenges related to the supply of power in implanted left ventricular assist devices (LVADs) by means of transcutaneous drivelines. In effect of that, we present the preventive measures and post-operative protocols that are regularly employed to address the leading problem of driveline infections. Due to the lack of reliable wireless solutions for power transfer in LVADs, the development of new driveline configurations remains at the forefront of different strategies that aim to power LVADs in a less destructive manner. To this end, skin damage and breach formation around transcutaneous LVAD drivelines represent key challenges before improving the current standard of care. For this reason, we assess recent strategies on the surface functionalization of LVAD drivelines, which aim to limit the incidence of driveline infection by directing the responses of the skin tissue. Moreover, we propose a class of power transfer systems that could leverage the ability of skin tissue to effectively heal short diameter wounds. In this direction, we employed a novel method to generate thin conductive wires of controllable surface topography with the potential to minimize skin disruption and eliminate the problem of driveline infections. Our initial results suggest the viability of the small diameter wires for the investigation of new power transfer systems for LVADs. Overall, this review uniquely compiles a diverse number of topics with the aim to instigate new research ventures on the design of power transfer systems for IMDs, and specifically LVADs.

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New Treatment for Driveline Infection Following Implantation of a Ventricular Assist Device

Cited by 6 publications

References 9 publications

Ventricular Assist Device Driveline Infections: A Systematic Review

Ventricular Assist Device Driveline Infections: A Systematic Review

Systems of conductive skin for power transfer in clinical applications

Amiodarone

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