Baclofen pump pocket infection: a case report of successful salvage with muscle flap

Bishara S Atiyeh; Shady N Hayek; Ghassan S Skaf; Ali Al Araj; Roukoz B Chamoun

doi:10.1111/j.1742-4801.2006.00179.x

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Baclofen pump pocket infection: a case report of successful salvage with muscle flap

Journal article

Open access

Peer reviewed

Baclofen pump pocket infection: a case report of successful salvage with muscle flap

Bishara S Atiyeh, Shady N Hayek, Ghassan S Skaf, Ali Al Araj and Roukoz B Chamoun

International Wound Journal, Vol.3(1), pp.23-28

03/2006

DOI: 10.1111/j.1742-4801.2006.00179.x

PMCID: PMC7951267

PMID: 16650208

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Abstract

Programmable pump for continuous infusion of intrathecal baclofen, an agonist of the inhibitory neurotransmitter gamma-aminobutyric acid, is nowadays being widely used to control spasticity. The most common complications leading to explantation of the pumps are skin breakdown and infection at the pump implantation site which cannot be effectively treated without pump removal. We report a 37-year-old man who developed a baclofen pump pocket infection that did not respond to antibiotic therapy. Because the continuation of intrathecal baclofen administration was critical to the patient, and because the high cost of the pump precluded its prompt replacement, the pump was salvaged using the ipsilateral rectus abdominis muscle that was elevated on its inferior vascular pedicle and wrapped around the pump. Abdominal skin was then approximated, leaving a small portion of exposed muscle overlying the refill site that was covered by a split-thickness skin graft. Continuous intrathecal baclofen administration was never discontinued. Three months later, the pump's refill site could be easily identified manually for pump refill. There were no signs of recurrent infection during the 2-year follow-up period.

Baclofen pump pocket infection

Muscle flap

Prosthetic salvage

Details

Title: Subtitle: Baclofen pump pocket infection: a case report of successful salvage with muscle flap
Creators: Bishara S Atiyeh - American University of Beirut Medical Center
Shady N Hayek - American University of Beirut Medical Center
Ghassan S Skaf - American University of Beirut Medical Center
Ali Al Araj - American University of Beirut Medical Center
Roukoz B Chamoun - American University of Beirut Medical Center
Resource Type: Journal article
Publication Details: International Wound Journal, Vol.3(1), pp.23-28
Publisher: Blackwell Publishing Ltd/Inc; Oxford, UK; Malden, USA
DOI: 10.1111/j.1742-4801.2006.00179.x
PMID: 16650208
PMCID: PMC7951267
ISSN: 1742-4801
eISSN: 1742-481X
ISSN: 1742-4801
eISSN: 1742-481X
Number of pages: 6
Language: English
Date published: 03/2006
Academic Unit: Surgery
Record Identifier: 9984702716902771

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