"Reverse J Shaped " Skin Flap and Cranial Bone Groove for Shunt Hardware: A New Technique for Patients with Fragile Skin.

Abstract

Shunt systems are not perfect devices and can cause severe complications. Complications may originate from problems related to the valve, the patient, or the surgery and are more common in neonates, infants, especially preterm, by reason of the special characteristics of these patients. We, therefore, have successfully developed a useful and viable surgical technique in order to provide helpful aspects to the surgical issues mentioned above. This technique includes a "reverse J shaped" skin incision nonintersecting the shunt's hardware and distal catheter to reduce wound problems to a minimum by opening a "bone groove". We believe that the above technique described by us will both reduce issues such as scalp ulceration, wound dehiscence, and shunt exposure in premature and pediatric hydrocephalus cases with a friable scalp, and eliminate a cosmetic problem in hydrocephalic patients of all ages.