Amit R Persad, Syed Uzair Ahmed, Rosalie Mercure-Cyr, Karen Waterhouse, Aleksander M Vitali
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We collected demographic data, including postoperative infections, reoperations, and complications, associated with the IPGs. This cohort was then compared with a historical cohort of consecutive patients undergoing surgery before envelope usage (October 2007-April 2014).</p><p><strong>Results: </strong>In the pre-envelope cohort of 151 IPGs placed in 116 patients, there were 18 culture-confirmed infections (11.9%). In the antibacterial envelope cohort of 233 IPGs placed in 185 patients, there were 5 culture-confirmed infections (2.1%). The absolute risk reduction of the antibacterial envelope was 9.85% (95% CI 4.3%-15.4%, P < .01). The number needed to treat was 10.1 (95% CI 6.5-23.1, P < .01) envelopes to prevent 1 IPG infection.</p><p><strong>Conclusion: </strong>We saw a reduced rate of infections in the antibacterial envelope cohort. Although this is likely multifactorial, our results suggest a benefit of antibacterial envelopes on infection after neuromodulation surgery.</p>","PeriodicalId":520730,"journal":{"name":"Operative neurosurgery (Hagerstown, Md.)","volume":" ","pages":"413-419"},"PeriodicalIF":0.0000,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Use of Antibacterial Envelopes for Prevention of Infection in Neuromodulation Implantable Pulse Generators.\",\"authors\":\"Amit R Persad, Syed Uzair Ahmed, Rosalie Mercure-Cyr, Karen Waterhouse, Aleksander M Vitali\",\"doi\":\"10.1227/ons.0000000000000367\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Neuromodulation unit placement carries a historic infection rate as high as 12%. Treatment of such requires surgical removal and a long course of systemic antibiotics. Antibiotic-impregnated envelopes have been effective in preventing infection in implantable cardiac devices. At our center, 1 surgeon uses these envelopes with all implanted neuromodulation units.</p><p><strong>Objective: </strong>To assess the efficacy of antibacterial envelopes in prevention of infection in neuromodulation device placement.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of consecutive implantable pulse generator (IPG) unit implantation with an antibacterial envelope at a single center between October 2014 and December 2019. We collected demographic data, including postoperative infections, reoperations, and complications, associated with the IPGs. This cohort was then compared with a historical cohort of consecutive patients undergoing surgery before envelope usage (October 2007-April 2014).</p><p><strong>Results: </strong>In the pre-envelope cohort of 151 IPGs placed in 116 patients, there were 18 culture-confirmed infections (11.9%). In the antibacterial envelope cohort of 233 IPGs placed in 185 patients, there were 5 culture-confirmed infections (2.1%). The absolute risk reduction of the antibacterial envelope was 9.85% (95% CI 4.3%-15.4%, P < .01). The number needed to treat was 10.1 (95% CI 6.5-23.1, P < .01) envelopes to prevent 1 IPG infection.</p><p><strong>Conclusion: </strong>We saw a reduced rate of infections in the antibacterial envelope cohort. 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引用次数: 1
摘要
背景:神经调节单元放置的历史感染率高达12%。这种疾病的治疗需要手术切除和长期的全身抗生素治疗。抗生素浸渍包膜在预防植入式心脏装置感染方面是有效的。在我们中心,一名外科医生使用这些包膜来植入所有的神经调节装置。目的:评价抗菌膜在神经调节装置置入中预防感染的效果。方法:对2014年10月至2019年12月在单中心连续植入抗菌包膜的植入式脉冲发生器(IPG)进行回顾性队列研究。我们收集了与IPGs相关的人口统计数据,包括术后感染、再手术和并发症。然后将该队列与使用包膜前连续接受手术的患者的历史队列(2007年10月- 2014年4月)进行比较。结果:在116例患者的151例ipg包膜前队列中,有18例培养确诊感染(11.9%)。在185名患者的233个ipg抗菌包膜队列中,有5个培养确诊感染(2.1%)。抗菌包膜绝对风险降低9.85% (95% CI 4.3% ~ 15.4%, P <. 01)。需要治疗的人数为10.1例(95% CI 6.5-23.1, P <.01)包膜预防1 IPG感染。结论:我们看到抗菌包膜组的感染率降低。虽然这可能是多因素的,但我们的结果表明抗菌膜对神经调节手术后感染有好处。
Use of Antibacterial Envelopes for Prevention of Infection in Neuromodulation Implantable Pulse Generators.
Background: Neuromodulation unit placement carries a historic infection rate as high as 12%. Treatment of such requires surgical removal and a long course of systemic antibiotics. Antibiotic-impregnated envelopes have been effective in preventing infection in implantable cardiac devices. At our center, 1 surgeon uses these envelopes with all implanted neuromodulation units.
Objective: To assess the efficacy of antibacterial envelopes in prevention of infection in neuromodulation device placement.
Methods: We conducted a retrospective cohort study of consecutive implantable pulse generator (IPG) unit implantation with an antibacterial envelope at a single center between October 2014 and December 2019. We collected demographic data, including postoperative infections, reoperations, and complications, associated with the IPGs. This cohort was then compared with a historical cohort of consecutive patients undergoing surgery before envelope usage (October 2007-April 2014).
Results: In the pre-envelope cohort of 151 IPGs placed in 116 patients, there were 18 culture-confirmed infections (11.9%). In the antibacterial envelope cohort of 233 IPGs placed in 185 patients, there were 5 culture-confirmed infections (2.1%). The absolute risk reduction of the antibacterial envelope was 9.85% (95% CI 4.3%-15.4%, P < .01). The number needed to treat was 10.1 (95% CI 6.5-23.1, P < .01) envelopes to prevent 1 IPG infection.
Conclusion: We saw a reduced rate of infections in the antibacterial envelope cohort. Although this is likely multifactorial, our results suggest a benefit of antibacterial envelopes on infection after neuromodulation surgery.