Abstract
Percutaneous lead exit site infection continues to be a major complication with LVADs. Usually these patients experience acute trauma that causes separation of the skin from the percutaneous lead, setting the stage for inflammation, drainage, maceration and eventual infection. We evaluated the use of Calcium-Sodium Alginate (Kaltostat ConvaTec, Princeton, NJ) dressing, known for its moisture absorbing and wound healing properties. Patients with exudative LVAD exit site breakdown were treated with daily Kaltostat dressings. They were regularly monitored for the amount and quality of the wound drainage. We compared our results using Kaltostat, to our previous experience in patients treated with the standard wound management protocol without Kaltostat. Six patients with exudative exit site wounds were treated with Kaltostat dressings. Improvement was documented in all wounds after an average of 13 days (range 1–39 days). The mean extent of driveline separation from the percutaneous lead decreased by 75% in one month from 12 mm to 3 mm. Complete wound healing occurred in all these patients without any surgical intervention. The average duration of therapy was 2.6 months. In five control patients, standard treatments without Kaltostat were used over an average of 6.2 months with none demonstrating complete resolution. Three of these wounds (60%) deteriorated during the treatment course, and 4 (80%) required surgical revision. Our early experience suggests Kaltostat dressing can successfully be used for the treatment of exudative exit site breakdown in LVAD patients.
Published Version
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