Limitations
Our study has various limitations. First, the small number of patients
included could impact our results, particularly in our lack of recurrent
infection in both groups. However, to our knowledge, this is the largest
trial evaluating the impact of capsulectomy on outcomes. Moreover, it is
impossible to determine whether our favorable results are due to CHG
scrubbing or if they can be achieved by saline irrigation only since
wound irrigation removes debris and bacteria in experimental models and
is associated with a reduction in the risk of surgical site
infections.(26) Although both groups underwent saline irrigation, the
volume of fluid used during saline irrigation differed between groups,
as a larger volume was used in patients in the CHG group to thoroughly
remove the CHG. However, it is implausible; that irrigation alone could
explain our positive results since saline irrigation is frequently
performed as a standard procedure for treating CIED infection. Finally,
as this is a retrospective study, it is prone to confounding bias as
there were significant differences in baseline characteristics of
patient populations. As such, this study should be considered an
observational study of a change in practice.