Expansion of the subcutaneous compartment by umbilicus resection for intrathecal pump placement: the "Karagoz-Hacivat technique"

Abstract

BACKGROUND AND OBJECTIVES:Intrathecal baclofen (ITB) for severe spasticity can encounter complications such as wound dehiscence and ulcers because of elevated intracompartmental pressure within the abdominal subcutaneous and subfascial pocket housing the pump. We propose an innovative technique to manage ITB wound ulcers.METHODS:Resecting the umbilicus create a more spacious and less tension-prone pocket for the ITB pump.RESULTS:Between 2015 and 2023, we implanted ITB pumps in 65 patients. Among them, 5 patients presented with skin ulcer or dehiscence underwent surgery using the novel technique. Postoperative follow-up revealed successful wound healing, with no further wound-related complications.CONCLUSION:The proposed technique provides effective and practical solution to wound and skin complications related to ITB pump. Moreover, it may serve as a viable preemptive strategy during the initial implantation of the ITB pump in selected patients.