A systematic review on prevention and management of wound infections from cochlear implantation

Clin Otolaryngol. 2019 Nov;44(6):1059-1070. doi: 10.1111/coa.13444. Epub 2019 Oct 15.

Abstract

Objective of review: Surgical site infections are a recognised complication of cochlear implant (CI) surgery with significant morbidity. Our aim was to search for the optimum prevention and management strategy to deal with this issue.

Type of review: Systematic review.

Search strategy: A systematic literature search was undertaken from the databases of Embase, CINAHL, MEDLINE® , Web of Science, Scopus and Cochrane Library according to the predefined inclusion and exclusion criteria.

Evaluation method: All relevant titles, abstracts and full-text articles were reviewed by two authors who resolved any differences by discussion and consultation with senior authors.

Results: Fourteen articles were included in our review. The overall quality of evidence was low with the vast majority of the studies being retrospective case series and expert opinions. No randomised controlled trials were noted. We found consistent reports that intraoperative prophylactic antibiotics should be given to all patients undergoing CI and that the vast majority of CI wound infections had grown Staphylococcal spp. or Pseudomonas spp.

Conclusion: Our review has not identified any reliable or reproducible strategies to prevent and deal with wound infections after CI. We strongly encourage further research within this field and would suggest that a consensus of opinions from a multidisciplinary panel of experts may be a pragmatic way forward as an effective guide.

Keywords: cochlear implants; complications; prevention and control; surgical wound infection.

Publication types

  • Systematic Review

MeSH terms

  • Cochlear Implantation*
  • Humans
  • Surgical Wound Infection / prevention & control*