Surgical site infections in cancer patients with intrathecal drug delivery devices

Maura M. Scanlon, Halena M. Gazelka, Susan M. Moeschler, Bryan C. Hoelzer, W. Michael Hooten, Markus A. Bendel, Tim J. Lamer

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Objectives. Our purpose was to determine the incidence of surgical site infection (SSI) in cancer patients receiving an intrathecal drug delivery system (IDDS) and compare that rate with the incidence of SSI in the general population receiving an IDDS or spinal cord stimulator. We attempted to describe risk factors for SSIs in cancer patients treated with IDDS in terms of exposure to cancer treatments. Design. Retrospective review. Setting. Large tertiary care center. Patients. Cancer patients receiving an IDDS in 2006–2013. Methods. The incidence of SSI was determined according to the US Centers for Disease Control and Prevention definition. Medication regimens and current cancer treatment were investigated to identify immunocompromised patients during IDDS placement. Microbacteriology, treatment, and overall outcomes were investigated. Results. Sixty-four patients had an IDDS implanted in 2006–2013. SSI developed in four patients (6.2%). All four patients had received chemotherapy or radiotherapy within three months before implantation. Three of the three were receiving dexamethasone, and three of the four required explantation of the IDDS. Conclusion. The incidence of SSI was at the upper end of the published infection rates for IDDS. The risk of SSI may be increased in this population because of factors that alter the patient’s immune status, including concomitant corticosteroid use, radiotherapy near the SSI, and presence of immunomodulators. The identification and mitigation of certain risk factors for this population may prevent infection in future patients.

Original languageEnglish (US)
Pages (from-to)520-525
Number of pages6
JournalPain Medicine (United States)
Volume18
Issue number3
DOIs
StatePublished - 2017

Keywords

  • Cancer
  • Implantation
  • Infections
  • Intrathecal

ASJC Scopus subject areas

  • Clinical Neurology

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    Scanlon, M. M., Gazelka, H. M., Moeschler, S. M., Hoelzer, B. C., Hooten, W. M., Bendel, M. A., & Lamer, T. J. (2017). Surgical site infections in cancer patients with intrathecal drug delivery devices. Pain Medicine (United States), 18(3), 520-525. https://doi.org/10.1093/pm/pnw203