Surgical complications of implanting pacemakers

Siddons, Harold; Nowak, Katarzyna

doi:10.1002/bjs.1800621202

Cited by 41 publications

(19 citation statements)

References 15 publications

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“…In contrast, reviews of cardiac pacemakers [14,15] have reported rates of 0.5 Á/2.5% for wound infections and 4.1% for skin necrosis with pacemaker or wire exposure. A review of 7205 of these implants [15] showed a mean rate of surgical complications of 5.1%. Figures for CIs compare favorably with those reports.…”

Section: Discussionmentioning

confidence: 85%

“…In addition, hip replacement revision rates have remained rather stable: in 1993 and 1997 revision rates were :/16.8% and 17.3%, respectively [13]. In contrast, reviews of cardiac pacemakers [14,15] have reported rates of 0.5 Á/2.5% for wound infections and 4.1% for skin necrosis with pacemaker or wire exposure. A review of 7205 of these implants [15] showed a mean rate of surgical complications of 5.1%.…”

Section: Discussionmentioning

confidence: 89%

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Latin American experience with the cochlear implant

Goycoolea

2005

Acta Oto-Laryngologica

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 89%

Latin American experience with the cochlear implant

Goycoolea

2005

Acta Oto-Laryngologica

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“…Anatomical variations may preclude use of either the cephalic or external jugular veins (Borrie and Lichter, 1975), but the subclavian veins are constantly sited (Keeri-Szanto, 1956). When the cephalic vein is used a puckered scar may result (Siddons and Nowak, 1975) and the superficial position of a catheter in the external jugular vein renders it liable to extrusion (Bluestone et al, 1965;Borrie and Lichter, 1975).…”

Section: Discussionmentioning

confidence: 99%

“…Though the cephalic and external jugular veins are not ideally suited as routes of access to the heart for permanent pacing catheters, these veins are commonly used (Siddons and Nowak, 1975;Sowton, 1976). The present study describes the results of using the subclavian vein for permanent cardiac pacing in patients with symptomatic complete atrioventricular block.…”

mentioning

confidence: 97%

Use of subclavian vein for permanent cardiac pacing.

Mcneill¹,

Taylor²

1978

Heart

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The subclavian vein has been used to implant permanent pacing catheters in 40 patients with symptomatic heart block. Though the cephalic and external jugular veins are usually preferred for this purpose in Britain, the use of these veins has certain disadvantages. In this study subclavian venepuncture by the infraclavicular approach was performed without diffculty and found to be a safe procedure. Three months after implantation, 7.5 per cent of patients had developed catheter tip dislocation and 87.5 per cent of patients were entirely free of complications.

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“…We felt that the presence of pus and organisms was evidence of generator pocket infection rather than a "foreign body" reaction and accordingly have included them in the analysis. Other authors'6 have reported the frequent presence of sterile effusions found at box change, but there have been fewer reports of purulent fluid indicating prior or active infection in the pouch.20 (4) PENICILLIN HYPERSENSITIVITY Thirteen patients (2 6%) reported penicillin allergy. None received antibiotics.…”

Section: ) Diagnosis Of Infectionmentioning

confidence: 98%

Prophylactic antibiotics for cardiac pacemaker implantation. A prospective trail.

Muers¹,

Arnold²,

Sleight³

1981

Heart

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SUMMARY A prospective trial was conducted to assess the value of prophylactic antibiotic treatment in preventing postoperative infection of permanent transvenous pacemaker systems. Four hundred and thirty-one patients were randomly allocated to treatment (234) or no-treatment (197) groups. Treated patients received systemic benzylpenicillin and flucloxacillin just before operation and one and six hours afterwards.Nine primary generator pocket infections occurred without evidence of wound dehiscence or skin erosion. Seven infections were in untreated patients and two in treated patients. Antibiotic prophylaxis diminishes the risk of infection after pacemaker implantations.Pacemaker generator pocket infection has remained a major complication of implantation since the first units were used 25 years ago. Sepsis rates in recent series have varied between 0-3%1 and 12-6%.2It is common practice to employ prophylactic antibiotic treatment at the time of implantation in the expectation that the number of infections will be reduced. Some retrospective analyses of uncontrolled series have supported this view3 but Siddons and Nowak4 have suggested that the protective effect is small. Furthermore there is no uniformity of practice in the use of antibiotics. In these circumstances there was clearly a need for a prospective trial to evaluate the effectiveness of prophylactic antibiotic treatment at the time of pacemaker implantation. SubjectsWe studied all patients who underwent elective permanent pacemaker implantation (new systems) non-elective reoperations, such as the repositioning of previously implanted electrodes, were studied separately.Four hundred and thirty-one patients were randomly allocated to treatment or no-treatment groups with the single exception of 13 patients who reported allergy to penicillin and who did not receive antibiotics. The patients were allocated according to the last digit of their hospital record number: odd numbers received treatment and even numbers did not.The antibiotic regimen was: flucloxacillin 1 g together with benzylpenicillin 600 mg intramuscularly, one hour before operation one hour and six hours after operation.All operations were carried out under local anaesthesia after premedication with either intravenous diazepam or morphine sulphate and droperidol. All procedures took place in the same operating theatre using standard instrument packs, and aseptic technique. This theatre was used on other occasions for minor surgical procedures. Chlorhexidine 4% was used for hand cleansing. Providoneiodine 10% aqueous solution was used for skin preparation on the night before the operation and on the morning of operation, and was followed by providone-iodine 7-5% with surfactants at the time of operation.5 All new systems consisted of standard intravenous electrodes attached to subcutaneous or subfascial generators. Cephalic, perctoral,6 539 on 9 May 2018 by guest. Protected by copyright.

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Surgical complications of implanting pacemakers

Cited by 41 publications

References 15 publications

Latin American experience with the cochlear implant

Latin American experience with the cochlear implant

Use of subclavian vein for permanent cardiac pacing.

Prophylactic antibiotics for cardiac pacemaker implantation. A prospective trail.

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