A Novel Skin and Fascia Opening for Subfascial Inserting of Intrathecal Baclofen Pump

Research output: Contribution to journalArticle

Abstract

Objective The aim of this article is to introduce a new skin and fascia opening for intrathecal baclofen pump implantation in the abdomen, with the purpose of reducing complications related to wound breakdown. Methods We introduce a novel way of cutaneous and fascial opening that leads two opposed “L shaped” incisions. Results This method entails numerous advantages. The first advantage is avoiding the direct alignment of overlapped sutures, which creates a locus minoris resistentiae that can weaken and break under the push of the pump. Another advantage consists of an increased obstruction against deep extension of infective processes from cutaneous origin. The wide opening of the subfascial pocket permits the implantation of any type of pump available, and it reduces complexities in reopening the pouch for pump replacement. It also permits the fastening of all anchoring systems usually present in pumps. Another advantage is the improved possibility of careful muscle cauterization thanks to the wide fascia opening, with reduced risk of postsurgical hematoma. Our results showed a reduction of wound complications with this method. Conclusions This method could contribute to reducing the rate of wound complications and patient discomfort.

Original languageEnglish
Pages (from-to)244-248
Number of pages5
JournalWorld Neurosurgery
Volume110
DOIs
Publication statusPublished - Feb 1 2018

Fingerprint

Baclofen
Fascia
Skin
Wounds and Injuries
Cautery
Hematoma
Abdomen
Sutures
Muscles

Keywords

  • Baclofen pump
  • Incision
  • Pump implantation
  • Spasticity
  • Subfascial pump

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

@article{430996f778da4db5abe477136ebaad54,
title = "A Novel Skin and Fascia Opening for Subfascial Inserting of Intrathecal Baclofen Pump",
abstract = "Objective The aim of this article is to introduce a new skin and fascia opening for intrathecal baclofen pump implantation in the abdomen, with the purpose of reducing complications related to wound breakdown. Methods We introduce a novel way of cutaneous and fascial opening that leads two opposed “L shaped” incisions. Results This method entails numerous advantages. The first advantage is avoiding the direct alignment of overlapped sutures, which creates a locus minoris resistentiae that can weaken and break under the push of the pump. Another advantage consists of an increased obstruction against deep extension of infective processes from cutaneous origin. The wide opening of the subfascial pocket permits the implantation of any type of pump available, and it reduces complexities in reopening the pouch for pump replacement. It also permits the fastening of all anchoring systems usually present in pumps. Another advantage is the improved possibility of careful muscle cauterization thanks to the wide fascia opening, with reduced risk of postsurgical hematoma. Our results showed a reduction of wound complications with this method. Conclusions This method could contribute to reducing the rate of wound complications and patient discomfort.",
keywords = "Baclofen pump, Incision, Pump implantation, Spasticity, Subfascial pump",
author = "Pietro Fiaschi and Armando Cama and Gianluca Piatelli and Paolo Moretti and Marco Pavanello",
year = "2018",
month = "2",
day = "1",
doi = "10.1016/j.wneu.2017.11.086",
language = "English",
volume = "110",
pages = "244--248",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - A Novel Skin and Fascia Opening for Subfascial Inserting of Intrathecal Baclofen Pump

AU - Fiaschi, Pietro

AU - Cama, Armando

AU - Piatelli, Gianluca

AU - Moretti, Paolo

AU - Pavanello, Marco

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Objective The aim of this article is to introduce a new skin and fascia opening for intrathecal baclofen pump implantation in the abdomen, with the purpose of reducing complications related to wound breakdown. Methods We introduce a novel way of cutaneous and fascial opening that leads two opposed “L shaped” incisions. Results This method entails numerous advantages. The first advantage is avoiding the direct alignment of overlapped sutures, which creates a locus minoris resistentiae that can weaken and break under the push of the pump. Another advantage consists of an increased obstruction against deep extension of infective processes from cutaneous origin. The wide opening of the subfascial pocket permits the implantation of any type of pump available, and it reduces complexities in reopening the pouch for pump replacement. It also permits the fastening of all anchoring systems usually present in pumps. Another advantage is the improved possibility of careful muscle cauterization thanks to the wide fascia opening, with reduced risk of postsurgical hematoma. Our results showed a reduction of wound complications with this method. Conclusions This method could contribute to reducing the rate of wound complications and patient discomfort.

AB - Objective The aim of this article is to introduce a new skin and fascia opening for intrathecal baclofen pump implantation in the abdomen, with the purpose of reducing complications related to wound breakdown. Methods We introduce a novel way of cutaneous and fascial opening that leads two opposed “L shaped” incisions. Results This method entails numerous advantages. The first advantage is avoiding the direct alignment of overlapped sutures, which creates a locus minoris resistentiae that can weaken and break under the push of the pump. Another advantage consists of an increased obstruction against deep extension of infective processes from cutaneous origin. The wide opening of the subfascial pocket permits the implantation of any type of pump available, and it reduces complexities in reopening the pouch for pump replacement. It also permits the fastening of all anchoring systems usually present in pumps. Another advantage is the improved possibility of careful muscle cauterization thanks to the wide fascia opening, with reduced risk of postsurgical hematoma. Our results showed a reduction of wound complications with this method. Conclusions This method could contribute to reducing the rate of wound complications and patient discomfort.

KW - Baclofen pump

KW - Incision

KW - Pump implantation

KW - Spasticity

KW - Subfascial pump

UR - http://www.scopus.com/inward/record.url?scp=85037629636&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85037629636&partnerID=8YFLogxK

U2 - 10.1016/j.wneu.2017.11.086

DO - 10.1016/j.wneu.2017.11.086

M3 - Article

VL - 110

SP - 244

EP - 248

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -