{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:07:33Z","timestamp":1789016853392,"version":"build-2803163510"},"reference-count":97,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Driveline infections (DLIs) remain the predominant device\u2010specific complication in patients supported by left ventricular assist devices (LVADs) serving as a major source of morbidity, recurrent hospitalization, and mortality. Despite their clinical impact, the prevention and early management of DLIs lack standardization, particularly within outpatient and home\u2010based care environments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Objectives<\/jats:title>\n                    <jats:p>The original 2020 DESTINE proposal introduced a standardized dressing protocol and a prevention\u2010oriented staging system for driveline exit\u2010site management. However, subsequent clinical real\u2010world experience revealed limitations, including overly complex early\u2010stage subcategorization and the absence of contemporary guidance on wound care, including fixation strategies, antiseptic agents, and adjunctive therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Updated Recommendations<\/jats:title>\n                    <jats:p>DESTINE 2.0 provides expert recommendations to address these gaps. The updated framework features a streamlined five\u2010stage system that consolidates previous subcategories into unambiguous, actionable clinical stages. Enhanced recommendations are provided for driveline immobilization, stage\u2010stratified antiseptic agent selection, and skin barrier preservation. Furthermore, the protocol incorporates adjunctive therapies including cold atmospheric plasma and closed\u2010incision negative pressure wound therapy. Expanded guidance covers modifiable patient\u2010level risk factors, perioperative prophylaxis, showering safety, caregiver education, digital documentation, and stage\u2010directed antibiotic therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>By providing a practical, integrated framework applicable to multidisciplinary care settings, DESTINE 2.0 aims to optimize infection\u2010free survival, minimize healthcare utilization, and improve quality of life for patients on long\u2010term mechanical circulatory support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aor.70237","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:14:48Z","timestamp":1789013688000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevention and Management of Driveline Infections in Ventricular Assist Device Patients: The\n                    <scp>DESTINE<\/scp>\n                    2.0 Staging Proposal and Expert Recommendations"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9974-8091","authenticated-orcid":false,"given":"Alexander M.","family":"Bernhardt","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, University Heart and Vascular Center Hamburg University Hospital Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Lauenroth","sequence":"additional","affiliation":[{"name":"Department for Thoracic\u2010 and Cardiovascular Surgery Heart &amp; Diabetes Center, North Rhine\u2010Westphalia  Bad Oeynhausen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Mueller","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin III (Kardiologie, Angiologie Und Internistische 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