Successful use of human amniotic allograft membrane in the treatment of recalcitrant driveline infections.

Driveline infections represent a significant source of morbidity and mortality in left ventricular assist device (LVAD) patients. Driveline infection occur in up to 40% of cases and have recurrence rates up to 50%. Current literature fails to demonstrate specific interventions capable of reducing prevalence of recalcitrant driveline infections (including serial debridement, muscle flap coverage of the driveline, driveline relocation, and device exchange). Human cryopreserved decellularized amniotic membrane (HCDAM) has been effectively used in chronic non-healing infected diabetic ulcers and reconstructive orthopedic and ophthalmology surgery for its advantageous biological properties. With no univocal consensus treatment option, we firstly explored HCDAM application in recalcitrant driveline infection and we describe the successful outcome in a patient who failed previous management with serial debridement. By wrapping HCDAM around the driveline we were able to obtain a positive tissue response leading to infection resolution.