Skin Erosion and Exteriorisation of a Cardiac Implantable Electronic Device: Modified Surgical Approach

Authors

  • Faizus Sazzad Research Fellow & Cardiac Surgeon, Department of Surgery (CTVS), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  • Farzana B Ibrahim Assistant Professor, Department of Plastic & Reconstructive Surgery, BIRDEM General Hospital, Dhaka, Bangladesh
  • Md Saidur Rahman Khan Professor & Senior Consultant, Department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh

DOI:

https://doi.org/10.3329/jbcps.v38i3.47064

Keywords:

Cardiac implantable electronic device, Permanent Pacemaker, Exteriorization

Abstract

Skin erosion and exteriorization of the commonest cardiac implantable electronic device (CIED) is usually caused by localized infection as a result of “pocket” infection. But, there are other recognized factors including an advanced age with thin, fragile skin with precarious subcutaneous fat. So, exteriorisation of a generator, and/or a lead, is not always associated with bacterial contamination followed by antibiotic therapy and contra-lateral re-implantation strategy. Hence, it does not always make the removal of the material an obligation. Our notable findings in a rare case of such exteriorization stimulate us to look for and implement a modified surgical technique. This 93-year-old extremely aged wonderfully co-operative, multi-morbid woman had multiple episodes of skin erosion and fixation, re-fixation surgery till the best result achieved. We present a new technique for cardiac pacing allowing for full patient recovery via an alternative surgical way of CIED relocation.

J Bangladesh Coll Phys Surg 2020; 38(3): 155-157

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Published

2020-05-12

How to Cite

Sazzad, F., Ibrahim, F. B., & Khan, M. S. R. (2020). Skin Erosion and Exteriorisation of a Cardiac Implantable Electronic Device: Modified Surgical Approach. Journal of Bangladesh College of Physicians and Surgeons, 38(3), 155–157. https://doi.org/10.3329/jbcps.v38i3.47064

Issue

Section

Case Reports