Clinical use of antibacterial mesh envelopes in cardiovascular electronic device implantations

David S Hirsh,1,2 Heather L Bloom1,2 1Department of Cardiovascular Medicine, School of Medicine, Emory University, Atlanta, GA, USA; 2Department of Cardiovascular Medicine, Atlanta Veterans Affairs Medical Center, Decatur, GA, USA Abstract: Cardiovascular implantable electronic device system infec...

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Autores principales:	Hirsh DS, Bloom HL
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/f9a4e3a83cd24688832471fe46695645
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spelling	oai:doaj.org-article:f9a4e3a83cd24688832471fe466956452021-12-02T02:39:26ZClinical use of antibacterial mesh envelopes in cardiovascular electronic device implantations1179-1470https://doaj.org/article/f9a4e3a83cd24688832471fe466956452015-01-01T00:00:00Zhttp://www.dovepress.com/clinical-use-of-antibacterial-mesh-envelopes-in-cardiovascular-electro-peer-reviewed-article-MDERhttps://doaj.org/toc/1179-1470 David S Hirsh,1,2 Heather L Bloom1,2 1Department of Cardiovascular Medicine, School of Medicine, Emory University, Atlanta, GA, USA; 2Department of Cardiovascular Medicine, Atlanta Veterans Affairs Medical Center, Decatur, GA, USA Abstract: Cardiovascular implantable electronic device system infection is a serious complication of cardiac device implantation and carries with it a risk of significant morbidity and mortality. In the last 15 years, expansions of indications for cardiac devices have resulted in much higher volumes of much sicker patients being implanted, carrying significant risk of infection. Coagulase (-) Staphylococcus and Staphylococcus aureus are responsible for the majority of these infections, and these organisms are increasingly resistant to methicillin. The Aigis™ envelop is a Food and Drug Administration–approved implantable mesh that is impregnated with antibiotics that can be placed in the surgical incision prior to closure. The antibiotics elute off the mesh for 7–10 days, providing in vivo surgical site coverage with rifampin and minocyclin. This paper reviews the three retrospective clinical trials published in peer-reviewed journals and the interim analysis of the two ongoing prospective trials that have been presented at international conferences. Overall consensus is that the Aigis™ offers significant risk reduction for cardiovascular implantable electronic device infection. We then give a comprehensive discussion of how to use the Aigis™ envelop in the clinical setting, comparing the manufacturer’s recommendations with our extensive clinical experience. Keywords: pacemaker, defibrillator, cardiac electronic implantable device, infection, Aigis™Hirsh DSBloom HLDove Medical PressarticleMedical technologyR855-855.5ENMedical Devices: Evidence and Research, Vol 2015, Iss default, Pp 71-78 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical technology R855-855.5
spellingShingle	Medical technology R855-855.5 Hirsh DS Bloom HL Clinical use of antibacterial mesh envelopes in cardiovascular electronic device implantations
description	David S Hirsh,1,2 Heather L Bloom1,2 1Department of Cardiovascular Medicine, School of Medicine, Emory University, Atlanta, GA, USA; 2Department of Cardiovascular Medicine, Atlanta Veterans Affairs Medical Center, Decatur, GA, USA Abstract: Cardiovascular implantable electronic device system infection is a serious complication of cardiac device implantation and carries with it a risk of significant morbidity and mortality. In the last 15 years, expansions of indications for cardiac devices have resulted in much higher volumes of much sicker patients being implanted, carrying significant risk of infection. Coagulase (-) Staphylococcus and Staphylococcus aureus are responsible for the majority of these infections, and these organisms are increasingly resistant to methicillin. The Aigis™ envelop is a Food and Drug Administration–approved implantable mesh that is impregnated with antibiotics that can be placed in the surgical incision prior to closure. The antibiotics elute off the mesh for 7–10 days, providing in vivo surgical site coverage with rifampin and minocyclin. This paper reviews the three retrospective clinical trials published in peer-reviewed journals and the interim analysis of the two ongoing prospective trials that have been presented at international conferences. Overall consensus is that the Aigis™ offers significant risk reduction for cardiovascular implantable electronic device infection. We then give a comprehensive discussion of how to use the Aigis™ envelop in the clinical setting, comparing the manufacturer’s recommendations with our extensive clinical experience. Keywords: pacemaker, defibrillator, cardiac electronic implantable device, infection, Aigis™
format	article
author	Hirsh DS Bloom HL
author_facet	Hirsh DS Bloom HL
author_sort	Hirsh DS
title	Clinical use of antibacterial mesh envelopes in cardiovascular electronic device implantations
title_short	Clinical use of antibacterial mesh envelopes in cardiovascular electronic device implantations
title_full	Clinical use of antibacterial mesh envelopes in cardiovascular electronic device implantations
title_fullStr	Clinical use of antibacterial mesh envelopes in cardiovascular electronic device implantations
title_full_unstemmed	Clinical use of antibacterial mesh envelopes in cardiovascular electronic device implantations
title_sort	clinical use of antibacterial mesh envelopes in cardiovascular electronic device implantations
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/f9a4e3a83cd24688832471fe46695645
work_keys_str_mv	AT hirshds clinicaluseofantibacterialmeshenvelopesincardiovascularelectronicdeviceimplantations AT bloomhl clinicaluseofantibacterialmeshenvelopesincardiovascularelectronicdeviceimplantations
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Clinical use of antibacterial mesh envelopes in cardiovascular electronic device implantations

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