Implantable baclofen pump as an adjuvant in treatment of pressure sores.
Currently, the success of ulcer treatment is limited by the high recurrence and complication rates. Spasticity is an important contributing factor to ulcer recurrence, and intrathecal baclofen is an effective method to reduce spasticity. Spasticity creates friction, shear, and mobility impairment resulting in wound dehiscence, flap loss, infection, and hematoma. Spasticity can be managed pharmacologically and surgically; baclofen is the drug of choice. Baclofen inhibits spasticity by blocking excitatory neurotransmitters in the spinal dorsal horn. Intrathecal baclofen maximizes the dose delivered to spinal receptors and minimizes the side effects associated with oral baclofen. Case reports of intrathecal baclofen used in patients with pressure sores demonstrate the use of intrathecal baclofen to improve reconstructive outcomes in spastic patients.
Division of Plastic Surgery, Georgetown University Hospital, Washington, DC 2002, USA. s.a.mess@att.net
Sarah A
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Mess
Sylvia
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Kim
Steven
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Davison
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Heckler
D000328:Adult; D001418:Baclofen / Q000008:administration & dosage*; D018755:GABA Agonists / Q000008:administration & dosage*; D006801:Humans; D015918:Infusion Pumps, Implantable; D007278:Injections, Spinal; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D010264:Paraplegia / Q000150:complications; D003668:Pressure Ulcer / Q000209:etiology / Q000628:therapy*
D018755:GABA Agonists; D009125:Muscle Relaxants, Central; D001418:Baclofen