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.