Infection is the most common complication in patients undergoing ventricular assist device (VAD) implantation. Driveline exit site (DLES) infection is the most frequent VAD infection and is a significant cause of adverse events in VAD patients, contributing to morbidity, even mortality, and repetitive hospital readmissions. There are many risk factors for driveline infection (DLI) including younger age, smaller constitution of patients, obesity, exposed velour at the DLES, longer duration of device support, lower cardiac index, higher heart failure score, DLES trauma, and comorbidities such as diabetes mellitus, chronic kidney disease, and depression. The incidence of DLI depends also on the device type. Numerous measures to prevent DLI currently exist. Some of them are proven, whereas the others remain controversial. Current recommendations on DLES care and DLI management are predominantly based on expert consensus and clinical experience of the certain centers. However, careful and uniform DLES care including obligatory driveline immobilization, previously prepared sterile dressing change kits, and continuous patient education are probably crucial for prevention of DLI. Diagnosis and treatment of DLI are often challenging because of certain immunological alterations in VAD patients and microbial biofilm formation on the driveline surface areas. Although there are many conservative and surgical methods described in the DLI treatment, the only possible permanent solution for DLI resolution in VAD patients is heart transplantation. This systematic review brings a comprehensive synthesis of recent data on the prevention, diagnostic workup, and conservative and surgical management of DLI in VAD patients.

感染是接受心室辅助装置 (VAD) 植入的患者最常见的并发症。动力传动系统出口部位 (DLES) 感染是最常见的 VAD 感染，是 VAD 患者不良事件的重要原因，导致发病率、甚至死亡率和重复住院。传动系感染 (DLI) 有许多危险因素，包括年龄较小、患者体质较小、肥胖、DLES 处暴露的丝绒、较长的设备支持时间、较低的心脏指数、较高的心力衰竭评分、DLES 创伤和合并症，例如糖尿病、慢性肾病和抑郁症。DLI 的发生率还取决于设备类型。目前存在许多预防 DLI 的措施。其中一些已被证明，而另一些仍然存在争议。目前关于 DLES 护理和 DLI 管理的建议主要基于专家共识和某些中心的临床经验。然而，仔细和统一的 DLES 护理，包括强制传动系固定、先前准备的无菌换药包和持续的患者教育可能对预防 DLI 至关重要。由于 VAD 患者的某些免疫学改变和传动系统表面区域的微生物生物膜形成，DLI 的诊断和治疗通常具有挑战性。尽管在 DLI 治疗中描述了许多保守和手术方法，但 VAD 患者 DLI 解决的唯一可能永久解决方案是心脏移植。该系统评价全面综合了有关预防、诊断检查、