Use of an Antibacterial Envelope in Spinal Cord Stimulation Reduces the Rate and Severity of Iatrogenic Infections

Abstract

AimTo examine if the use of an antibacterial envelope (TYRX) decreases the rate of postoperative infection in chronic pain patients undergoing treatment with spinal cord stimulation (SCS) involving device implantation. MethodSingle center retrospective cohort study comparing postoperative infections rates in non-TYRX recipients from 2018-2020 with recipients of a TYRX antibacterial envelope from 2020-2021. Infection was registered if a patient received any form of antibiotic treatment after hospital discharge within a follow-up period of 100 days. ResultsA total of 198 patients were included. 100 in the TYRX group and 98 in the non-TYRX group. There were no significant differences between the two groups regarding age, BMI, smoking, diabetes, and use of immunosuppression.The overall infection rate was 5.6%. The infection rate was 4% in the TYRX group and 7.1% in the non-TYRX group (p=0.6). However, the 4 cases of postoperative infection in the TYRX group could be effectively managed with oral antibiotics alone, whereas 6 out of the 7 patients in the non-TYRX group required intravenous antibiotics. Moreover, device explantation was necessary in 3 of these patients suggesting the event of more severe infections in the non-TYRX group (p=0.014). ConclusionThe TYRX antibacterial envelope displayed infection rates reducing capabilities, along with a clear tendency to reduce revision surgeries and system removals due to infections.