Barrett Thomas F, Rasouli Jonathan J, Taub Peter, Kopell Brian H
Department of Neurosurgery, Mount Sinai Medical Center, New York, New York, USA.
Department of Plastic Surgery, Mount Sinai Medical Center, New York, New York, USA.
World Neurosurg. 2018 Mar;111:41-46. doi: 10.1016/j.wneu.2017.12.045. Epub 2017 Dec 16.
While deep brain stimulation (DBS) is a relatively safe procedure, skin erosion is a commonly reported hardware complication that can threaten the DBS system. Patients with Parkinson disease are especially at risk for this complication due to their autonomic dysregulation and impaired nutrition. Early detection of impending skin erosion allows for intervention that may prevent hardware destruction. Here we report a novel technique to address this complication preemptively. We describe the use of an acellular dermal matrix to prevent skin erosion in 20 patients with Parkinson disease who were treated with DBS and showed signs of impending skin erosion.
Twenty patients with signs of impending hardware erosion were identified. An acellular dermal matrix was surgically placed under the at-risk skin overlying the DBS lead.
None of the 20 patients treated with this technique went on to require further revision surgery or removal of hardware.
Surgical placement of acellular dermal matrix in patients identified as having impending hardware erosions is a safe and cost-effective way to prevent hardware complications.
虽然深部脑刺激（DBS）是一种相对安全的手术，但皮肤侵蚀是一种常见的硬件并发症，可能会威胁到DBS系统。帕金森病患者由于自主神经调节功能障碍和营养受损，尤其容易出现这种并发症。早期发现即将发生的皮肤侵蚀可进行干预，从而可能防止硬件损坏。在此，我们报告一种新的技术来预先解决这一并发症。我们描述了使用脱细胞真皮基质来预防20例接受DBS治疗且出现即将发生皮肤侵蚀迹象的帕金森病患者的皮肤侵蚀情况。
确定20例有即将发生硬件侵蚀迹象的患者。通过手术将脱细胞真皮基质放置在DBS导线上方有风险的皮肤下方。
接受该技术治疗的20例患者均未继续需要进一步的翻修手术或移除硬件。
对于被确定有即将发生硬件侵蚀的患者，手术植入脱细胞真皮基质是预防硬件并发症的一种安全且经济有效的方法。
