Buchanan Emily, Yoo Dale
Cardiac Electrophysiology, Heart Rhythm Specialists, PLLC, McKinney, USA.
Cureus. 2021 Jan 31;13(1):e13037. doi: 10.7759/cureus.13037.
Cardiac implantable electronic device (CIED) infections are a serious complication of both initial device implants and generator change procedures, and they are associated with a wide range of presentations. Reported rates of CIED infections vary widely from 0.1% to 19.9%, but it is estimated that they occur in 0.5% of initial device implants and 1-7% of subsequent implants. It is widely accepted that the administration of local antibiotics within the pocket as well as extracellular matrices (ECMs) can be utilized to reduce the incidence of CIED infections. We describe a case where the use of an additional biological ECM scaffold sutured directly into the incision site was utilized in addition to a biological ECM pouch in order to reduce the risk of infection. We propose that biological ECM could be utilized to reinforce the incision site directly as well as ECM within the pocket to reduce the instances of CIED infections. Further investigation of the use of biological ECM to prevent infection is warranted and paramount to further decrease the number of complications associated with device implantation.
心脏植入式电子设备（CIED）感染是初始设备植入和发生器更换手术的严重并发症，且与多种临床表现相关。报道的CIED感染率差异很大，从0.1%到19.9%不等，但据估计，它们在0.5%的初始设备植入以及1%-7%的后续植入中发生。人们普遍认为，在囊袋内使用局部抗生素以及细胞外基质（ECM）可用于降低CIED感染的发生率。我们描述了一个病例，除了使用生物ECM囊袋外，还将额外的生物ECM支架直接缝合到切口部位，以降低感染风险。我们建议，生物ECM可用于直接加固切口部位以及囊袋内的ECM，以减少CIED感染的发生。对使用生物ECM预防感染进行进一步研究是必要的，对于进一步减少与设备植入相关的并发症数量至关重要。
