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
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
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DOI：
10.1159/000324903
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发表时间：
2011-01-01
影响因子：
1.7
通讯作者：
Chang, Jin Woo
中科院分区：
文献类型：
--
作者：
Park, Young Seok;Kang, Jeong-Han;Chang, Jin Woo
背景：本研究的目的是介绍双c形皮肤切口和调整的双层毛刺孔的联合手术，以防止头皮深部脑刺激（DBS）手术的皮肤并发症。方法：2000年3月至2010年3月，在268例患者中植入504个DBS电极。我们纳入了双侧和单侧DBS手术病例，包括帕金森病、震颤、疼痛、强迫症和顽固性癫痫发作，伴有颅骨和IPG插入手术，但排除了运动皮质刺激和脊髓刺激。自2006年3月以来，118例患者采用皮肤直切口，113例患者仅采用双c形皮肤切口，2009年8月以来，37例患者采用双c形皮肤切口联合双层毛刺孔。我们比较了先前的直或c形皮肤切口与联合手术的头皮伤口并发症和温哥华疤痕量表的高度亚量表。结果：268例患者中有8例头皮糜烂伴感染（3.0%），6例头皮脱落（2.2%）。在采用双c皮切口或调整的双层毛刺钻孔技术之前，我们在118例患者中有5例（4.2%）头皮糜烂。引入c形切口后，仅有3例（2.7%）出现头皮糜烂。然而，37例患者均采用双c形皮肤切口和双层毛刺钻孔技术后，无患者发生头皮糜烂。用温哥华疤痕量表的高度子量表测量的头皮肿块在联合手术中更美观。结论：联合手术预防了DBS手术相关的皮肤并发症，抗张强度大，血管供应受损少，美容效果好。这种有希望的方法可以防止与DBS手术相关的不必要的皮肤并发症，并提高患者满意度。巴塞尔S. Karger股份有限公司版权所有
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. Copyright (C) 2011 S. Karger AG, Basel