Impact of Gentamicin-Impregnated Collagen Sponge on the Incidence of Access Related Infections After Full-Support Microaxial Flow Pump Therapy.

BACKGROUND

Surgically implanted microaxial flow pumps (mAFP) are increasingly used for cardiogenic shock treatment. Standard mAFP explantation is performed bedside with a shortening of the vascular prosthesis, which may represent a potential source of infection in future. We analyzed the impact of gentamicin-impregnated collagen sponge (GICS) application in the wound during mAFP explantation on the incidence of prosthetic graft infections.

METHODS

Between 01/2020 and 07/2024, 235 patients underwent bedside full-support mAFP explantation at our institution. Since 11/2022, GICS has been routinely applied in 115 patients, while 120 previously were treated without it.

RESULTS

In the GICS-group, after a median follow-up of 221 [24; 351] days, 17 (14.8%) patients developed graft infection, resulting in 0.23 events per patient year (EPPY); surgery was necessary in 16 patients (13.9%). In the control group, after a median follow-up of 399 [113; 654] days, infection occurred in 14 (11.7%) cases, 0.10 EPPY; surgical removal of the graft was necessary in 12 (10%). The GICS-groups presented an increased risk for graft infections: sHR 2.49 [1.11; 5.59], p = 0.027. After propensity score matching for relevant demographic parameters, there was no significant difference in the risk reduction of total graft infections sHR 1.92 [0.79; 4,72], p = 0.15.

CONCLUSIONS

Local application of GICS did not reduce the risk of access site infections in patients undergoing bedside explantation of mAFP from the graft surgically anastomosed to an axillary artery.