Cihan Isler, Huseyin Mert Cerci, Semih Baghaki, Yekta Servet Aydin, Süreyya Toklu, Mehmet Murat Hanci
{"title":"Expansion of the Subcutaneous Compartment by Umbilicus Resection for Intrathecal Pump Placement: The \"Karagoz-Hacivat Technique\".","authors":"Cihan Isler, Huseyin Mert Cerci, Semih Baghaki, Yekta Servet Aydin, Süreyya Toklu, Mehmet Murat Hanci","doi":"10.1227/ons.0000000000001131","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>Intrathecal baclofen (ITB) for severe spasticity can encounter complications such as wound dehiscence and ulcers because of elevated intracompartmental pressure within the abdominal subcutaneous and subfascial pocket housing the pump. We propose an innovative technique to manage ITB wound ulcers.</p><p><strong>Methods: </strong>Resecting the umbilicus create a more spacious and less tension-prone pocket for the ITB pump.</p><p><strong>Results: </strong>Between 2015 and 2023, we implanted ITB pumps in 65 patients. Among them, 5 patients presented with skin ulcer or dehiscence underwent surgery using the novel technique. Postoperative follow-up revealed successful wound healing, with no further wound-related complications.</p><p><strong>Conclusion: </strong>The proposed technique provides effective and practical solution to wound and skin complications related to ITB pump. Moreover, it may serve as a viable preemptive strategy during the initial implantation of the ITB pump in selected patients.</p>","PeriodicalId":54254,"journal":{"name":"Operative Neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.7000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Operative Neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1227/ons.0000000000001131","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/27 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background and objectives: Intrathecal baclofen (ITB) for severe spasticity can encounter complications such as wound dehiscence and ulcers because of elevated intracompartmental pressure within the abdominal subcutaneous and subfascial pocket housing the pump. We propose an innovative technique to manage ITB wound ulcers.
Methods: Resecting the umbilicus create a more spacious and less tension-prone pocket for the ITB pump.
Results: Between 2015 and 2023, we implanted ITB pumps in 65 patients. Among them, 5 patients presented with skin ulcer or dehiscence underwent surgery using the novel technique. Postoperative follow-up revealed successful wound healing, with no further wound-related complications.
Conclusion: The proposed technique provides effective and practical solution to wound and skin complications related to ITB pump. Moreover, it may serve as a viable preemptive strategy during the initial implantation of the ITB pump in selected patients.
期刊介绍:
Operative Neurosurgery is a bi-monthly, unique publication focusing exclusively on surgical technique and devices, providing practical, skill-enhancing guidance to its readers. Complementing the clinical and research studies published in Neurosurgery, Operative Neurosurgery brings the reader technical material that highlights operative procedures, anatomy, instrumentation, devices, and technology. Operative Neurosurgery is the practical resource for cutting-edge material that brings the surgeon the most up to date literature on operative practice and technique