Efficacy of Antimicrobial Silver-Plated Dressings Compared to Usual Care in Preventing Left Ventricular Assist Device Driveline Infections.

BACKGROUND: Left ventricular assist device (LVAD) driveline infections (DLIs) represent one of the most common adverse events in LVAD patients. This study investigates the effectiveness of a silver-plated antimicrobial dressing (Silverlon, Bravida Medical) in addition to usual driveline wound care for DLI-prevention. The primary outcome was six-months freedom from DLI. Secondary outcomes included independent risk factors for DLI, freedom from DLI-related hospital readmission, freedom from negative pressure wound therapy (NPWT) and temporal changes in DESTINE wound staging. METHODS: This single center cohort study included 61 patients implanted with a HeartMate 3 LVAD between 2022 and 2025 (8.2% female; median age 61 (55; 67 IQR) years; BMI 27.2 (±4.42 STD) kg/m2). Starting with the first follow-up visit (FFUV) after hospital discharge, 39 patients received usual wound care, while 22 patients additionally received Silverlon. RESULTS: The Silverlon group demonstrated a significantly greater freedom from DLI (100% vs. 71.8%; p = 0.017). No independent predictors of DLI were identified due to the complete absence of DLIs in the Silverlon group (0 vs. 11 events); multivariable Cox regression effect could not be mathematically estimated. The Silverlon group showed 100% freedom from DLI-related readmission and NPWT therapy (vs. 97.4%; p = 0.45). DESTINE stages 0-1 predominated within the Silverlon group; severe stages (3, 4) occurred exclusively within the usual care group (p > 0.22). CONCLUSION: Given the substantial burden of DLI, integrating silver-plated wound dressings into standard LVAD wound care appears to be a safe and effective strategy, associated with enhanced wound healing and a reduction in DLI incidence.