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A combination procedure with double C-shaped skin incision and dual-floor burr hole method to prevent skin erosion on the scalp and reduce postoperative skin complications in deep brain stimulation

Authors
 Park Y.S.  ;  Kang J.-H.  ;  Kim H.Y.  ;  Kang D.W.  ;  Chang W.S.  ;  Kim J.P.  ;  Chang J.W. 
Citation
 STEREOTACTIC AND FUNCTIONAL NEUROSURGERY, Vol.89(3) : 178-184, 2011 
Journal Title
STEREOTACTIC AND FUNCTIONAL NEUROSURGERY
ISSN
 1011-6125 
Issue Date
2011
MeSH
Adult ; Aged ; Deep Brain Stimulation/adverse effects* ; Dermatologic Surgical Procedures ; Electrodes, Implanted/adverse effects ; Female ; Humans ; Male ; Middle Aged ; Scalp/surgery* ; Surgical Wound Infection/etiology ; Surgical Wound Infection/prevention & control* ; Trephining
Keywords
Deep brain stimulation ; Burr hole
Abstract
BACKGROUND: The purpose of this study was to introduce a combination procedure with double C-shaped skin incision and an adjusted dual-floor burr hole to prevent skin complications on the scalp with deep brain stimulation (DBS) surgery.

METHODS: Between March 2000 and March 2010, 504 DBS electrodes were implanted in 268 patients. We included both bilateral and unilateral DBS surgery cases for Parkinson's disease, tremor, pain, obsessive-compulsive disorder and intractable seizure accompanied with cranial and IPG insertion procedure, but excluded motor cortex stimulation, and spinal cord stimulation. We used a straight skin incision in 118 patients, double C-shaped skin incision only in 113 patients since March 2006, and combined a double C-shaped skin incision and dual-floor burr hole in 37 patients since August 2009. We compared scalp wound complications and the height subscale of the Vancouver Scar Scale between previous straight or C-shaped skin incision and the combination procedure.

RESULTS: We had eight scalp erosions associated with infection (3.0%) and six disconnection (2.2%) cases among 268 patients. Before the use of the double C-skin incision or adjusted dual-floor burr hole technique, we had 5 (4.2%) scalp erosion cases among 118 patients. With the introduction of the C-shaped incision, only 3 patients (2.7%) developed scalp erosion. However, no patient among 37 patients developed scalp erosion after using both double C-shaped skin incision and dual-floor burr hole technique. Scalp bump measured by the height subscale of the Vancouver Scar Scale was more cosmetic in the combination procedure.

CONCLUSION: The combination procedure prevents skin complications associated with DBS surgery, with tensile strength, less impaired vascular supply and better cosmetic outcome. This promising approach prevents unwanted skin complications associated with DBS surgery and improves patient satisfaction.
Full Text
http://www.karger.com/Article/FullText/324903
DOI
10.1159/000324903
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Joo Pyung(김주평)
Park, Young Seok(박영석)
Chang, Won Seok(장원석) ORCID logo https://orcid.org/0000-0003-3145-4016
Chang, Jin Woo(장진우) ORCID logo https://orcid.org/0000-0002-2717-0101
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/94852
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