Hardware-Related Skin Problems of Deep Brain Stimulation

Kim, Myung-Ji; Chong, Kyu-Ha; Yun, Won-Ki; Kwon, Taek-Hyun; Kim, Jong-Hyun

Original article

Journal of the Korean Society of Stereotactic and Functional Neurosurgery 2018;14(2):29-33.
Published online September 30, 2018.

Hardware-Related Skin Problems of Deep Brain Stimulation

Myung-Ji Kim, Kyu-Ha Chong, Won-Ki Yun, Taek-Hyun Kwon, Jong-Hyun Kim

Department of Neurosurgery, Korea University Guro Hospital, Seoul, Korea

Abstract

Purpose
Deep brain stimulation (DBS)-related skin problems such as infection and skin erosion lead to increased patient morbidity. We aimed to evaluate the incidence of skin problems after deep brain stimulator insertion and assess possible risk factors.
Methods
Medical records of 45 patients who underwent DBS surgery at our center, from 2008 through 2017, were retrospectively reviewed. We categorized skin problem as post-operative infection and skin erosion.
Results
Six of 45 patients (13%) had DBS hardware-related infection and two of 45 patients (4%) had skin erosion. In three patients (3/45, 6.7%) with hardware-related infection, initial antibiotic therapy and surgical wound repair alone were successful. Hardware was partially saved in one patient (1/45, 2.2%), but complete removal was performed in two patients (2/45, 4.4%) after the failure of partial hardware removal or wound debridement.
Conclusions
An initial trial of antibiotic treatment could be successful in some cases, but medical treatment sometimes failed to prevent partial or total removal of hardware. None of the patient-related factors (gender, diabetes mellitus or smoking status, staged operation, age at the time of surgery, and body mass index) was significantly associated with an increased risk of infection.

Key Words: Deep brain stimulation, Complication, Skin erosion, Infection, Hardware-related, IPG implantation.