Preprint Case Report Version 1 Preserved in Portico This version is not peer-reviewed

Reinforcement of a Subcutaneous Pocket for Implantable Cardioverter Defibrillator Insertion Using Acellular Dermal Matrix: A Case Report

Jun Ho Choi
ORCID logo ,
Ho Jun Lee
,
Kwang Seog Kim
* ,
Hyung Wook Park
,
Insu Choi
ORCID logo ,
Jae Ha Hwang
,
Sam Yong Lee
Version 1 : Received: 6 March 2024 / Approved: 6 March 2024 / Online: 6 March 2024 (23:55:09 CET)

How to cite: Choi, J.H.; Lee, H.J.; Kim, K.S.; Park, H.W.; Choi, I.; Hwang, J.H.; Lee, S.Y. Reinforcement of a Subcutaneous Pocket for Implantable Cardioverter Defibrillator Insertion Using Acellular Dermal Matrix: A Case Report. Preprints 2024, 2024030375. https://doi.org/10.20944/preprints202403.0375.v1 Choi, J.H.; Lee, H.J.; Kim, K.S.; Park, H.W.; Choi, I.; Hwang, J.H.; Lee, S.Y. Reinforcement of a Subcutaneous Pocket for Implantable Cardioverter Defibrillator Insertion Using Acellular Dermal Matrix: A Case Report. Preprints 2024, 2024030375. https://doi.org/10.20944/preprints202403.0375.v1

Abstract

Thin people who undergo implant insertion into the chest wall face a high risk of implant exposure to the external environment. Five months after an 8-year-old boy underwent implantable cardioverter-defibrillator (ICD) implantation in a subcutaneous pocket in the left anterolateral chest wall to manage long QT syndrome, ICD replacement became necessary owing to exposure risk from distal and lateral thinning of the ICD pocket. Pocket rupture and exposure would increase the risk of infection; therefore, we performed ICD removal and primary pocket closure. Two weeks later, a new suprafascial pocket was created, acellular dermal matrix (ADM) was attached to the inner wall to prevent ICD protrusion, and a new ICD was inserted. One year postoperatively, the ADM was engrafted, and no complications were observed. A thin subcutaneous layer increases the risk of ICD implantation complications. Inner wall strengthening with ADM can help prevent pocket rupture.

Keywords

Acellular Dermal Matrix; Child; Defibrillators, Implanatable; Reinforcement; Subcutaneous Pocket

Subject

Medicine and Pharmacology, Surgery

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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