Infection and Exposure of Cardiovascular Implantable Electric Devices: the Applicability of Transvenous Entire-device Extraction and One-stage Wound Closure

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  • Imai Kazuya
    Department of Plastic and Reconstructive Surgery, Tokyo Medical and Dental University
  • Homma Tsutomu
    Department of Plastic and Reconstructive Surgery, Tokyo Medical and Dental University
  • Mori Hiroki
    Department of Plastic and Reconstructive Surgery, Tokyo Medical and Dental University
  • Goya Masahiko
    Department of Cardiovascular Medicine, Tokyo Medical and Dental University
  • Hirao Kenzo
    Department of Cardiovascular Medicine, Tokyo Medical and Dental University
  • Okazaki Mutsumi
    Department of Plastic and Reconstructive Surgery, Tokyo Medical and Dental University

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Other Title
  • 植え込み型心臓電子機器（CIEDs）の露出・感染に対する経静脈的デバイス全抜去法と一期的閉創の有用性の検討

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<p>　Cardiovascular implantable electric devices （CIEDs） are often prone to infections. As lead extraction techniques have been developed recently, all parts of the devices can now be easily extracted, changing the role of plastic surgeons. We reviewed 66 cases of infection from exposed CIEDs at our hospitalby dividing them into 3 groups as follows: wound closure in one stage （n = 12）, wound closure in two stages （n = 27）, and secondary healing （n = 27）. None of the patients had recurring infection, which suggested that entire-device lead extraction was effective for infection control. The one-stage wound closure group left the hospital the earliest among the three groups. Of the three patients with hematomas, one underwent one-stage closure and two underwent two-stage wound closure. This suggests that wound closure in one stage can shorten the hospital stay without increasing the risk of complications. Therefore, plastic surgeons should examine each patient before performing entire-device extraction because devices may be salvageable and suggest one-stage wound closure.</p>

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