Yu Genmiao, Huang Xiongmei, Lin Rongjia, Zheng Shengwu
Department of Burn and Plastic Surgery, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, Fuzhou, 350000, China.
Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350000, China.
BMC Cardiovasc Disord. 2025 Apr 23;25(1):305. doi: 10.1186/s12872-025-04769-7.
To evaluate the efficacy of negative-pressure wound therapy (NPWT) for cardiac implantable electronic device (CIED) pocket infection, eliminating the need for CIED and leads extraction.
The NPWT cohort consisted of 42 patients with CIED infection who were treated with NPWT from 2013 to 2023. Among them, 3 patients had a systemic infection and 1 patient had incomplete data. We performed a case-control study in which the NPWT group was compared with the conservative treatment group (40 patients). Main outcomes included failure rate (CIED/lead extraction during the 1-year follow-up, 30-day mortality/chronic infection, or infection-related mortality/recurrence) and infection-free time, with cure defined as absence of failure criteria.
A total of 38 patients with pocket infections were treated with NPWT from 2013 to 2023. NPWT was curative in 78.9% (n = 30 of 38) of patients who remained free of infection [median follow-up 12.63 months, interquartile range (IQR): 12.30-34.10 months]. Compared with patients who were treated conservatively, the two groups demonstrated balanced baseline characteristics. Patients who were treated with NPWT had a significantly higher cure rate (78.9% vs. 55.0%, n = 22 of 40; p = 0.025) and a longer mean infection-free time at the 1-year follow-up (338.00 vs. 285.20 days, p = 0.034).
NPWT is an effective alternative for patients with CIED pocket infections who are unsuitable or unwilling to undergo CIED and leads extraction.
This study was approved by the Chinese Clinical Trial Registry (Clinicaltrials.gov number: ChiCTR2300073560) on July 07, 2023.
评估负压伤口治疗（NPWT）对心脏植入式电子设备（CIED）囊袋感染的疗效，避免CIED及导线拔除的需求。
NPWT队列包括2013年至2023年接受NPWT治疗的42例CIED感染患者。其中，3例有全身感染，1例数据不完整。我们进行了一项病例对照研究，将NPWT组与保守治疗组（40例患者）进行比较。主要结局包括失败率（1年随访期间的CIED/导线拔除、30天死亡率/慢性感染或感染相关死亡率/复发）和无感染时间，治愈定义为无失败标准。
2013年至2023年共有38例囊袋感染患者接受了NPWT治疗。NPWT对78.9%（38例中的30例）未再发生感染的患者有效[中位随访12.63个月，四分位间距（IQR）：12.30 - 34.10个月]。与接受保守治疗的患者相比，两组基线特征均衡。接受NPWT治疗的患者治愈率显著更高（78.9%对55.0%，40例中的22例；p = 0.025），且在1年随访时平均无感染时间更长（338.00天对285.20天，p = 0.034）。
对于不适合或不愿接受CIED及导线拔除的CIED囊袋感染患者，NPWT是一种有效的替代方法。
本研究于2023年7月7日获得中国临床试验注册中心批准（Clinicaltrials.gov编号：ChiCTR2300073560）。
