Preventive Strategies for Driveline Infections in Ventricular Assist Devices: A Systematic Review

Driveline infection (DLI) is the most frequent infectious complication in patients supported with ventricular assist devices (VADs) and remains a major cause of morbidity and rehospitalization. This systematic review aimed to synthesize the available evidence on preventive strategies to reduce the incidence of DLI in adult VAD recipients. A systematic search of MEDLINE/PubMed, Scopus, CINAHL, Web of Science, the Cochrane Library, and APA PsycInfo up to April 1, 2026, followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Eleven observational studies were included. The infection prevention strategies evaluated included modifications to surgical tunneling, driveline stabilization techniques, standardized exit-site care protocols, antiseptic and dressing management, negative pressure wound therapy, and antibiotic prophylaxis. Surgical routing optimization, mechanical stabilization, and standardized exit-site care protocols were most consistently associated with reduced DLI incidence. In contrast, adjunctive interventions such as negative pressure wound therapy and prolonged antibiotic prophylaxis showed limited or inconsistent benefit. Current evidence remains limited to observational studies, highlighting the need for prospective and controlled research to establish standardized preventive strategies.