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一种用于固定心室辅助装置驱动线并预防出口部位感染的简易装置。

A simple device to secure ventricular assist device driveline and prevent exit-site infection.

作者信息

Baronetto Andrea, Centofanti Paolo, Attisani Matteo, Ricci Davide, Mussa Baudolino, Devotini Roger, Simonato Erika, Rinaldi Mauro

机构信息

Division of Cardiac Surgery, San Giovanni Battista Hospital 'Molinette', University of Turin, Turin, Italy.

出版信息

Interact Cardiovasc Thorac Surg. 2014 Apr;18(4):415-7. doi: 10.1093/icvts/ivt549. Epub 2014 Jan 14.

Abstract

OBJECTIVES

Driveline infections are one of the most common and important complications in patients with left ventricular assist device (LVAD). One of the causes favouring the development of this complication is the traumatism of the exit site, which occurs in response to movement of the driveline. In this work, we present a simple and feasible method to immobilize the driveline at the level of the exit site.

METHODS

From April 2013 until November 2013, 6 patients underwent implantation of HeartWare LVAD (HVAD) for an end-stage heart failure. When the patient has begun to mobilize after the implantation of the device, we have combined the use of two components with the aim of securing the driveline to the patient's skin: a StatLock system and a silicone suture.

RESULTS

No case of local traumatism and no case of local infection at the driveline were observed during the follow-up. No patient reported pain or swelling at the driveline exit site. All patients were satisfied with their quality-of-life and they do not report any limitations in their daily activities.

CONCLUSIONS

One of the major long-term complications in patients with LVAD is the development of infections of the exit site of the driveline. The trauma of this skin region promotes the onset and maintenance of an inflammatory process and local infectious. Avoiding excessive mobilization of the driveline is likely to reduce the incidence of infections of the exit site and improve the quality-of-life.

摘要

目的

在左心室辅助装置(LVAD)患者中,经皮导线感染是最常见且重要的并发症之一。导致该并发症发生的原因之一是导线出口部位的创伤,这是由导线移动引起的。在本研究中,我们提出了一种简单可行的方法,可在导线出口部位固定导线。

方法

2013年4月至2013年11月期间,6例患者因终末期心力衰竭接受了HeartWare左心室辅助装置(HVAD)植入术。在装置植入后患者开始活动时,我们联合使用了两种组件,目的是将导线固定在患者皮肤上:一种StatLock系统和一根硅胶缝线。

结果

随访期间未观察到导线局部创伤及局部感染病例。没有患者报告导线出口部位疼痛或肿胀。所有患者对其生活质量感到满意,且未报告日常活动有任何限制。

结论

LVAD患者主要的长期并发症之一是导线出口部位感染。该皮肤区域的创伤会促进炎症过程和局部感染的发生及持续。避免导线过度移动可能会降低出口部位感染的发生率并改善生活质量。

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