A recently published article by Peter T. Nguyen et
al.1” Impact of antimicrobial selection for
prophylaxis of left ventricular assist device surgical infections”
catches our eyes of interest. The efforts made by the authors are of
great importance and ought to be recognized by the readers. The last
point made by the author is that gram-positive organisms should be
covered as a priority during the implantation protocols of the left
ventricular assist device.
Considering the study’s limitations, the retrospective design of this
study raised many concerns as it is prone to be affected by reporting
bias due to not recalling properly, which leads to indecorous
documentation; this would be fair if the author has used data of the
present times. This study is also threatened by publication bias because
it has included participants from one selected location; it
significantly affects the methodological quality, which would be
corrected by conducting a multicenter study. In addition, the article
does not contain information about antibiotics used to prevent
infections. The other studies would have provided insight into the
specificity of this case.2,3 Meropenem, linezolide and
vancomycin were the most effective and widely used antibiotics of any
antibiotic used. Given scrub-in procedures, which is the weakness of
this study, another study highlighted that the driveline exit site
should be diluted with hydrogen peroxide, and germicide occlusive gauze
should be used for wound care.3 Upon completion of the
process, negative pressure wound therapy may be used for rapid recovery.
In addition, a study mentioned technical approaches for LVAD, including
standard strategies like full median sternotomy and sternotomy sparing
approaches like full lateral thoracotomy and less invasive strategy; the
author fails to mention these in this article.4 Finally, it was discovered that there was a patient follow-up issue
due to lack of knowledge or non-serious behaviour, which resulted in
inadequate documentation. However, it is seen in another
article,5 since they managed to stay in contact with
their patients 2 years after the transplant. References: