Postoperative infection unfortunately occurs everyday in the United States, as well as around

the world. Surgical site infections (SSI) occurring after the implantation of a cardiac implantable
electronic device (CIED) seems to be one of the more common occurrences. Some examples of a CIED
would be a pacemaker (used to help regulate a person's heartbeat), or an ICD (implantable cardioverterdefibrillater). An ICD will give the heart a shock if it falls out of rhythm for too long.
According to research done by Rabih Darouiche, Michael Mosier, and Jeffrey Voigt, The
incidence of surgical sit infection (SSI) after implantation of these devices ranges from 0.13% to
19.9%. Although, we do need to take into consideration the population of people in which these
devices are being placed. The majority of patients that are receiving CIEDs are elderly people, or
persons with other conditions (CHF, or conduction abnormalities). These types of patients are already
at a higher risk of infection because of their compromised immune systems due to disease and age.
The research within this article indicates specific safety precautions that can be implemented
into standard practice (if they are not already) to prevent, or reduce the rate of infections that occur
with this procedure. One obvious step which is used by every operating room in the world is cleaning
the site in which the procedure will be taking place. The question is, which antiseptic is best? It has
been discovered in prior randomized controlled trials (RCT) that chlorohexidine-alcohol antiseptics are
superior to povidone-iodine (Darouiche, 2012).
The other important factor is perioperative (before, after, or during surgery) antibiotic
prophylaxis. Giving antibiotics to a surgical patient to prevent infection. This article suggests that by
following these two antiseptic techniques properly, we can significantly reduce the risk of postoperative
SSIs.

Reference:
Darouiche, R., Mosier, M., & Voigt, J. (2012). Antibiotics and Antiseptics to prevent infection in
cardiac Rhythm Management Device Implantation surgery. Pacing & Clinical
Electrophysiology, 35(11), 1348-1360. doi:10.111/j.1540-8159. 2012.03506.x