Wound dehiscence after intrathecal pump implantation for cancer pain

Abstract

Intrathecal drug delivery devices offer a unique method of pain control from malignancy when more conservative methods fail. Such devices are also used to administer intrathecal baclofen in the treatment of spasticity and dystonia refractory to oral therapy. Unique challenges in wound healing exist in each patient. For patients with malignant pain, these challenges include malnourishment and infection secondary to immunosuppression from chemotherapy, both potentially increasing the risk of postoperative wound infection and impairing healing. Wound infection in intrathecal drug delivery most commonly occurs at the reservoir insertion site. Those infections are treated with long-term intravenous antibiotics or device revision or removal. Untreated, death may result from meningitis and sepsis. To prevent postoperative wound infection after intrathecal pump implantation, selection of patients, technique, insertion site, and wound care postoperatively must be reviewed carefully.