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The impact of povidone-iodine pocket irrigation use on pacemaker and defibrillator infections.

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  • Additional Information
    • Affiliation:
      Cleveland Clinic Foundation, Cleveland, OH
    • Subject Terms:
      Cross Infection -- Prevention and Control ; Defibrillators, Implantable ; Therapeutic Irrigation ; Pacemaker, Artificial ; Povidone-Iodine -- Pharmacodynamics
    • Subject Terms:
      Aged; Cross Infection -- Risk Factors; Data Analysis, Statistical; Descriptive Statistics; Female; Male; Nebraska; Ohio; Retrospective Design; Human
    • Abstract:
      BACKGROUND: Infection is a devastating complication of permanent pacemakers (PMs) implantable cardioverter defibrillators (ICDs). Many implanting physicians commonly use povidone-iodine solution to irrigate the device pocket before implanting the device. We sought to assess if such a measure would alter the rate of infection. METHODS: A total of 2,564 consecutive patients who received implantable PM or ICD devices between 1994 and 2002 were studied. Povidone-iodine was used for pocket irrigation in 53% and saline in 47%. A total of 18 (0.7%) patients developed pocket infections with 0.7% (10/1,359) in povidone-iodine (group I) and 0.6% (8/1,205) in saline (group II) pocket irrigation (p = ns). Groups I and II were studied for various clinical and demographic variables described in the results section. RESULTS: There was no statistical difference in the baseline demographic and clinical characteristics between groups I and II, respectively. ICDs were most frequently infected than PMs (56% vs 44%). Most (83%) of the devices were dual chamber. Reopening of the pocket for either lead or generator replacement had a higher incidence of infection than new implants (61% vs 39%). There was no difference in the use of preimplantation antibiotic prophylaxis. Late (61%) and deep pocket infections (78%) were more common than early (39%) and superficial infections (22%). Blood cultures were positive in 67% and Staphylococcus aureus was the common most pathogen (50%). The mean duration of antibiotics use after the diagnosis of device infection was 35 +/- 23 days with 72% requiring device explantation. The device was reimplanted on the contralateral side in 56% cases. One patient in each group died due to device infection and related complications. No significant allergy to iodine was seen in either group. CONCLUSION: Povidone-iodine irrigation of the subcutaneous pocket did not alter the rates of pocket infection after pacemaker/defibrillator implantation.
    • Journal Subset:
      Allied Health; Biomedical; Double Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA
    • ISSN:
      0147-8389
    • MEDLINE Info:
      PMID: NLM16105006 NLM UID: 7803944
    • Publication Date:
      20081219
    • Publication Date:
      20200708
    • DOI:
      http://dx.doi.org/10.1111/j.1540-8159.2005.00173.x
    • Accession Number:
      106389381
  • Citations
    • ABNT:
      LAKKIREDDY D et al. The impact of povidone-iodine pocket irrigation use on pacemaker and defibrillator infections. Pacing & Clinical Electrophysiology, [s. l.], v. 28, n. 8, p. 789–794, 2005. DOI 10.1111/j.1540-8159.2005.00173.x. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=106389381. Acesso em: 25 set. 2020.
    • AMA:
      Lakkireddy D, Valasareddi S, Ryschon K, et al. The impact of povidone-iodine pocket irrigation use on pacemaker and defibrillator infections. Pacing & Clinical Electrophysiology. 2005;28(8):789-794. doi:10.1111/j.1540-8159.2005.00173.x
    • APA:
      Lakkireddy D, Valasareddi S, Ryschon K, Basarkodu K, Rovang K, Mohiuddin SM, Hee T, Schweikert R, Tchou P, Wilkoff B, Natale A, & Li H. (2005). The impact of povidone-iodine pocket irrigation use on pacemaker and defibrillator infections. Pacing & Clinical Electrophysiology, 28(8), 789–794. https://doi.org/10.1111/j.1540-8159.2005.00173.x
    • Chicago/Turabian: Author-Date:
      Lakkireddy D, Valasareddi S, Ryschon K, Basarkodu K, Rovang K, Mohiuddin SM, Hee T, et al. 2005. “The Impact of Povidone-Iodine Pocket Irrigation Use on Pacemaker and Defibrillator Infections.” Pacing & Clinical Electrophysiology 28 (8): 789–94. doi:10.1111/j.1540-8159.2005.00173.x.
    • Harvard:
      Lakkireddy D et al. (2005) ‘The impact of povidone-iodine pocket irrigation use on pacemaker and defibrillator infections’, Pacing & Clinical Electrophysiology, 28(8), pp. 789–794. doi: 10.1111/j.1540-8159.2005.00173.x.
    • Harvard: Australian:
      Lakkireddy D, Valasareddi S, Ryschon K, Basarkodu K, Rovang K, Mohiuddin SM, Hee T, Schweikert R, Tchou P, Wilkoff B, Natale A & Li H 2005, ‘The impact of povidone-iodine pocket irrigation use on pacemaker and defibrillator infections’, Pacing & Clinical Electrophysiology, vol. 28, no. 8, pp. 789–794, viewed 25 September 2020, .
    • MLA:
      Lakkireddy D, et al. “The Impact of Povidone-Iodine Pocket Irrigation Use on Pacemaker and Defibrillator Infections.” Pacing & Clinical Electrophysiology, vol. 28, no. 8, Aug. 2005, pp. 789–794. EBSCOhost, doi:10.1111/j.1540-8159.2005.00173.x.
    • Chicago/Turabian: Humanities:
      Lakkireddy D, Valasareddi S, Ryschon K, Basarkodu K, Rovang K, Mohiuddin SM, Hee T, et al. “The Impact of Povidone-Iodine Pocket Irrigation Use on Pacemaker and Defibrillator Infections.” Pacing & Clinical Electrophysiology 28, no. 8 (August 2005): 789–94. doi:10.1111/j.1540-8159.2005.00173.x.
    • Vancouver/ICMJE:
      Lakkireddy D, Valasareddi S, Ryschon K, Basarkodu K, Rovang K, Mohiuddin SM, et al. The impact of povidone-iodine pocket irrigation use on pacemaker and defibrillator infections. Pacing & Clinical Electrophysiology [Internet]. 2005 Aug [cited 2020 Sep 25];28(8):789–94. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=106389381