gms | German Medical Science

Objective: Deep brain stimulation (DBS) hardware-related infection is one of the most serious complications, and may need additional interventions. DBS is part of a growing group of expensive implantable devices. We improved this study to reuse the internal pulse generator (IPG) after DBS infection, and to reduce the economic costs.

Method: A database of 102 patients who underwent DBS surgery was used in the study. Incidence, clinical characteristics and management of infections while reusing the IPG after DBS infection were analyzed and reported.

Results: The overall infection rate was 5.9% (6 of 102 patients) of the patients. The median time of infection was 3.5 months (range 1–6 months). The management consisted on total hardware removal followed by intravenous antibiotics. These patients recovered with no clinical signs of infection. In all patients, the IPG was infected. Staphylococcus was the causative organism. These patients underwent reimplantaion surgery at least 3 months after completion of antibiotic treatment to reimplant the devices. Explanted IPGs were used in all cases and no hardware related infection or other complications were observed after reimplantations. The mean follow-up period was 14 months (range 6–24 months).

Conclusions: Management of hardware-related infections can be challenging. Removal of the infected device is generally needed to establish cure of infection of the DBS. The medical and economic cost of these infections is enormous. The IPG can often be saved in infected patients. Thus, a significant cost burden is eliminated. Properly executed, reuse of IPG should markedly reduce the cost of these devices.