SALVAGING EXPOSED CARDIAC PACEMAKERS USING SUB-PECTORAL POCKET AND NEGATIVE PRESSURE WOUND THERAPY
Journal Title: IJAR-Indian Journal of Applied Research - Year 2019, Vol 9, Issue 4
Abstract
Introduction: Permanent cardiac pacemakers implanted over chest wall are prone to exposure and infection. The management of exposed pacemaker implants are controversial, and most of the time exposed devices are removed and a second device is implanted in an additional operation after days to weeks. Methods: Between Apr 2014 and Mar 2018, 24 patients were managed for exposed cardiac pacemakers. Most patients were operated within 14 days from exposure. All patients received perioperative appropriate antibiotics. In the absence of clinical signs of infection, NPWT was started for patients where there was more than one gauze piece soakage in 24 hours. Once soakage was less than 10 ml/day, implant was covered with local skin flap or placed in a sub-pectoral pocket and NPWT applied over the suture line. Mean follow-up post salvage procedure was 20 months. Results: Twenty two devices were saved. Only one grossly infected pacemaker was removed. In another patient implant got infected and exposed after four months of re-implantation and has to be removed and replaced. Conclusions: This protocol allows salvage of exposed permanent cardiac pacemaker implants even several days after exposure. A combination of NPWT and sub-pectoral muscle placement lead to salvage of the implant, saving cost and morbidity to the patient.
Authors and Affiliations
Dr (Col) D J Sharma
Keywords
Related Articles
- EP ID EP549935
- DOI -
- Views 62
- Downloads 0
HISTOLOGICAL STUDY- THE EFFECTS OF VARIOUS FIXATIVES ON KIDNEY
Fixation is the critical step in processing tissues. Following tissue removal from the body, autolysis begins and proceeds more or less quickly depending on many factors, including the level of enzymes or microorganism p...
A COMPARATIVE STUDY ON THE FINANCIAL PERFORMANCE OF THE J.K. CEMENT LIMITED AND ULTRATECH CEMENT LIMITED
Financial statement analysis is the method of reviewing and analysis a company's accounting report in order to analyse its past, present or projected future performance. This allows for better nancial and strategic deci...
EPIDERMOID CYST – CASE REPORT AND REVIEW OF LITERATURE
Epidermoid cysts are rare, slow‑growing, benign, developmental cysts that are derived from abnormally situated ectodermal tissue. Dermoid and epidermoid cysts in the oral cavity are uncommon and account for less than 0.0...
Nasolabial flap As A Reconstructive Option for the Management of Submucous Fibrosis- A Clinical Study
BACKGROUND: Oral submucous fibrosis is a peculiar ,progressive , inciduous, irreversible chron-ic de bilitating disease associated with restricted mouth opening, blanching and stiffness of mucosa, burning sensation in mo...
Quality of Service Based Improved Dynamic Source Routing in MANETs
Offering theQuality of Service (QoS)guarantee in a Mobile Ad-hoc Network (MANET) is a complicatedowing to node mobility, disputation for channel access, limitation centralized coordination and unreliable wireless channel...