Infection epidemiology, preventive measures and principles of best practices involving the skin and dressing of patients with a ventricular assist device: A scoping review

• Published in: Intensive & critical care nursing 2025-02, Vol.86, p.103840, Article 103840
• Main Authors: Brandão, Sara Michelly Gonçalves, Urasaki, Maristela Belletti Mutt, Yamada, Beatriz Farias Alves, Lemos, Dayanna Machado, Matos, Ligia Neres, Costa, Mariana Takahashi Ferreira, Nogueira, Paula Cristina, Santos, Vera Lucia Conceição de Gouveia
• Format: Article
• Language: English
• Subjects: Bacteria; Bandages - standards; Best practice; Biofilms; Clinical medicine; Coordinators; Dermatology; Dressing; Dressings; Epidemiology; Exudate; Gram-negative bacteria; Gram-positive bacteria; Heart failure; Heart-Assist Devices - adverse effects; Heart-Assist Devices - standards; Heart-Assist Devices - statistics & numerical data; Humans; Infection Control - methods; Infection Control - standards; Infections; Infectious diseases; Intensive care; Left ventricular assist device; Mechanically assisted circulatory support; Microbiota infections; Multidrug resistant organisms; Nurse specialists; Nursing; Organisms; Practice Guidelines as Topic; Prevention programs; Preventive medicine; Skin; Skin care; Skin Care - instrumentation; Skin Care - methods; Skin Care - nursing; Skin Care - standards; Specialists; Standardization; Staphylococcus infections
• ISSN: 0964-3397; 1532-4036; 1532-4036
• DOI: 10.1016/j.iccn.2024.103840

•What is already known about the topic?•Local care at the site of driveline exit differ among centers and skin disorders have only been minimally explored.•The current consensus on left ventricular assist devices does not address topical prophylaxis.•What this paper adds?•The most frequent infection continued to be from the driveline.•The microbiology of infection continues to be predominantly due to Staphylococcus.•This review provides an overview of the principles of best practices involving the skin and dressing of patients with a ventricular assist device without local dermatological diseases or infectious diseases.•It can make a difference in the outcome gathering together broad knowledge about ventricular assist devices from a technical, clinical and systemic perspective in the central figure of a professional. Specific knowledge of several domains for managing care in the driveline externalization area may be necessary for the broader application of left ventricular assist devices. This study aimed to map the recommendations for adult patients undergoing left ventricular assist device implantation. This scoping review, is being registered in the Open Science Framework under DOI https://doi.org/10.17605/OSF.IO/Q76B3 (https://osf.io/q76b3/). Left ventricular assist device coordinators and nurse specialists in dermatology and stomatherapy conducted a scoping review limited to the period between 2015 and 2022. The results of this scoping review will be discussed and presented separately in 3 articles. This third article synthesizes research evidence on the epidemiology of device infections, infection preventive measures, local skin care and dressings in adult patients with left ventricular assist devices. The initial search resulted in 771 studies. Sixty nine met the eligibility criteria and were included in the scoping review. Eighteen articles addressing the epidemiology of device infections, infection preventive measures, and local skin and dressing care that answered the question of this article were included. The most common bacterial pathogens reported have been Gram-positive bacteria, typically Staphylococcus species. With respect to infection preventive measures, there are evidence gaps in local skin care and transmission system dressings. The driveline still remains the most common type of device infection. There exists imperfect knowledge on the standardization of care with the dressing and the area of skin for left ventricular assist device p