• Stereotact Funct Neurosurg · Jan 2013

    The risk of hardware infection in deep brain stimulation surgery is greater at impulse generator replacement than at the primary procedure.

    • Joshua Pepper, Ludvic Zrinzo, Bilal Mirza, Thomas Foltynie, Patricia Limousin, and Marwan Hariz.
    • Unit of Functional Neurosurgery, UCL Institute of Neurology, London, UK.
    • Stereotact Funct Neurosurg. 2013 Jan 1;91(1):56-65.

    Background/AimsInfection of implanted hardware after deep brain stimulation (DBS) has a significant impact on patient morbidity. We examined all patients who underwent DBS procedures over the last 9 years in our centre to assess the infection rate and possible factors related to surgery that may predispose to infection.MethodsSurgical reports and clinical notes were reviewed in 273 consecutive patients who underwent a total of 519 DBS-related procedures in our institute between November 2002 and September 2011.ResultsSixteen separate hardware-related infections occurred in 11 patients. Infections occurred in 3% of all procedures and 4% of all patients. The infection rate after implantable pulse generator (IPG) replacement surgery was more than three times higher than after de novo DBS surgery. In addition, male patients were more likely to develop device-related infections.ConclusionsIt is unclear why infection rates should be more than three times higher after IPG replacement surgery than after the de novo procedure. The former is a shorter and simpler procedure to conduct. Perhaps the use of better antimicrobial protection and rechargeable batteries may be useful strategies to reduce infections following IPG revision surgery.Copyright © 2012 S. Karger AG, Basel.

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