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One-step tunneling of DBS extensions--a technical note
Paulo Linhares1, Bruno Carvalho, Rui Vaz
1Department of Neurosurgery, Centro Hospitalar de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
Background:
Infection constitutes a serious adverse event in deep brain stimulation (DBS) surgery, being responsible for difficult therapeutic decisions that may ultimately involve the removal of implanted material. Some cases begin with skin erosion and wound dehiscence of the retroauricular incision, which is one of the most fragile points. Several techniques of rotation flaps and skin reconstruction, as well as prolonged antibiotic regimens, have been proposed as therapeutic options. To prevent the onset of this complication, the authors propose a one-step tunneling technique of DBS extensions, avoiding the opening of the retroauricular space.
Methods:
We describe a surgical technique of a one-step tunneling of DBS extensions in 20 patients submitted to subthalamic DBS for Parkinson's disease, avoiding the opening of the retroauricular space.
Results:
After implantation of the extensions using this technique, we had no erosions of the retroauricular skin, with a consequent reduction in the number of infections.
Conclusions:
The authors describe an easy surgical technique that allows reduction of wound and erosion complications, with great benefits for DBS patients.
Insights
A novel one-step tunneling technique for deep brain stimulation (DBS) extensions significantly reduces retroauricular wound complications and infections in Parkinson's disease patients.
Area of Science:
- Neurosurgery
- Medical Engineering
Background:
- Infections are a major complication in deep brain stimulation (DBS) surgery, potentially leading to device removal.
- Retroauricular incision sites are particularly vulnerable to skin erosion and wound dehiscence.
- Current prevention strategies include complex reconstruction techniques and extended antibiotic treatments.
Purpose of the Study:
- To introduce and evaluate a simplified surgical technique for tunneling DBS extensions.
- To prevent wound complications and reduce infection rates associated with DBS surgery.
Main Methods:
- A one-step tunneling technique for DBS extensions was employed in 20 patients undergoing subthalamic DBS for Parkinson's disease.
- This technique specifically avoids opening the retroauricular space during the tunneling procedure.
Main Results:
- No instances of retroauricular skin erosion were observed following the implantation using the described technique.
- A reduction in the incidence of infections was noted in patients who underwent this procedure.
Conclusions:
- The described surgical approach offers a straightforward method to minimize wound and erosion complications.
- This technique provides significant benefits for patients undergoing deep brain stimulation surgery.
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