Reuse of internal pulse generator in cases of infection after deep brain stimulation surgery.

BACKGROUND

Hardware-related infection after deep brain stimulation (DBS) is one of the most serious complications and may need additional interventions.

OBJECTIVES

To reuse the internal pulse generator (IPG) after DBS infection and to reduce the economic costs.

METHODS

A database of 102 patients who underwent DBS surgery was used in the study. The incidence, clinical characteristics and management of infections while reusing the IPG after DBS-related infection were analyzed and reported.

RESULTS

The overall infection rate was 5.9% (6 of 102 patients). Management consisted of total hardware removal followed by intravenous antibiotics. The IPG was at first kept in a solution, then rinsed with water and dried following sterilization with ethylene oxide gas at 38 °C for 18 h. When the treatment of the infection was finished, we reused the IPG and reimplanted the DBS. No hardware-related infection or other complications were observed after reimplantation.

CONCLUSIONS

Management of hardware-related infections can be challenging. The medical and economic costs associated with these infections are enormous. The IPG can often be saved in infected patients. Thus, a significant cost burden is eliminated. Properly executed, reuse of IPG should markedly reduce the costs of these devices.