Garcia-Rinaldi R, Revuelta J M, Bonnington L, Soltero-Harrington L
J Thorac Cardiovasc Surg. 1985 Jan;89(1):136-41.
Ten patients were treated for skin erosion and exposure of chronically implanted pacemakers. The pulse generators had been implanted either subcutaneously or in the subpectoral, submammary location. All patients were treated either by primary or secondary relocation of the pulse generator to deeper subfascial planes. Pacemakers relocated primarily to subfacial planes healed without resurfacing. Those pacemakers relocated to other superficial planes resurfaced but healed in a second subfascial translocation. Bacteriologic studies on these patients revealed that the organisms cultured or antibiotics utilized did not influence the fate of the relocated pulse generator. The subfascial location was the only determinant of the ultimate healing of the exposed pacemaker. We conclude that subfascial relocation of well-functioning pacemaker generators should be considered as an alternative to complete replacement of the unit.
10名患者因慢性植入式起搏器皮肤糜烂和外露而接受治疗。脉冲发生器植入于皮下或胸肌下、乳腺下位置。所有患者均通过将脉冲发生器初次或二次重新安置到更深的筋膜下平面进行治疗。主要重新安置到筋膜下平面的起搏器无需重新浮出表面即可愈合。那些重新安置到其他浅平面的起搏器会重新浮出表面，但在第二次筋膜下移位后愈合。对这些患者的细菌学研究表明，培养出的微生物或使用的抗生素并不影响重新安置的脉冲发生器的转归。筋膜下位置是外露起搏器最终愈合的唯一决定因素。我们得出结论，对于功能良好的起搏器发生器，应考虑将其筋膜下重新安置作为完全更换装置的替代方案。
