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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2002 April;15(2):75-8
A case of decubitus of port system and cure with cutaneous plastic surgery
Festa G., Balestrieri G., Cricri A. M., Cerbone D.
The authors describe a case of rejection of the reservoir of an implantable system in a patient subjected to chemotherapy for inoperable pancreatic carcinoma. The rejection was caused by a considerable weight loss, which had produced cutaneous hypotrophy owing to the progression of neoplasm. It was not possible to implant the port system in the other side of the chest, so the patient was subjected to plastic surgery using a cutaneous-pectoral advancing flap, according to the Schimanowski-Burow technique: the operation was performed under local anesthesia with 60 cc of saline solution and bupivacaina 2% without adrenalin; the unhealthy skin was removed by incision of a cutaneous and subcutaneous area of 7x12 cm; the chamber only was extirpated and a low profile model smaller than the previous one was implanted. It was caudally set up at about 4 cm compared with the preceding position and was anchored to the great pectoral fascia through 4 stitches of a slow absorption suture. Accurate haemostasis and a closure of the cutaneous defect were performed, using a cutaneous-pectoral advance not autonomized (7x14h) flap, according to Schimanowski-Burow technique. The follow-up lasted only three months because of the death of the patient caused by the progression of the pancreatic neoplasm. Cicatrization was excellent, the port was patent and the reservoir presented no problem, giving the possibility to perform infusive and chemotherapeutic treatments always using the implanted system.