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"Countersinking" of reservoir in an irradiated patients can decrease tension on scalp closure
Mansher Singh1, Arturo J Rios Diaz2, Alexandra J Golby3
1Department of Surgery, Division of Plastic Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA.
Surgical Neurology International
|August 4, 2015
Summary
A novel countersinking technique for subcutaneous reservoir placement reduces complications like wound dehiscence and device extrusion. This method is particularly beneficial for patients with thin, irradiated skin, ensuring tension-free wound closure.
Area of Science:
- Neurosurgery
- Medical Device Technology
Background:
- Subcutaneous reservoirs are crucial for cerebrospinal fluid access in therapies.
- Standard reservoir placement risks complications including hemorrhage, infection, malfunction, and malpositioning.
- Thin, irradiated skin poses additional challenges, increasing risks of wound dehiscence, infection, and device extrusion.
Observation:
- A "countersinking" technique was developed for reservoir placement.
- This involves creating a bony recess in the skull to accommodate the reservoir, reducing protrusion.
- The technique facilitates tension-free scalp closure and durable reservoir coverage.
Findings:
- The countersinking technique effectively accommodates the reservoir, minimizing protrusion.
- It enables tension-free wound closure, crucial for preventing dehiscence.
- In irradiated patients with thin skin, this method promotes effective wound healing.
Implications:
- Countersinking reservoirs can prevent complications like wound dehiscence and device extrusion in all patients.
- It offers a significant advantage for managing irradiated tissues and thin skin.
- This technique enhances the safety and durability of cerebrospinal fluid access therapies.
