title: Disulfiram Implantation for the Treatment of Alcoholism: Clinical Experiences from the Plastic Surgeon's Point of View.
abstract: BACKGROUND
  Disulfiram implantation is a widely used treatment alternative for alcohol abuse, yet reports on the surgical aspect of disulfiram implantation with respect to patient and drug-related treatment efficacy and wound complications are very limited. We present our clinical experiences with disulfiram implantation and discuss the surgical outcomes obtained with different anatomical planes for implantation.
  
  
  METHODS
  Medical records of all patients referred to our clinic from the psychiatry department between 2007 and 2013 for disulfiram implantation were retrospectively analyzed. Implantation was carried out using 10 sterile Disulfiram tablets (WZF Polfa S.A.), each tablet containing 100 mg of disulfiram. The procedure was carried out by implanting the tablets randomly in either a subcutaneous or an intramuscular plane. The location and the plane of implantation and the complications were recorded for each patient and compared to determine the differences in the outcomes.
  
  
  RESULTS
  A total of 32 implantation procedures were evaluated for this study. Twenty-five implants were placed in the intramuscular plane (78.2%), while seven implants were placed subcutaneously (21.8%). Exposure was encountered in three of the seven subcutaneous implants (42.9%), while no exposure was seen with the intramuscular implants. Incomplete absorption of the tablets was encountered in one patient with a previous subcutaneous implant who presented 1 year later for re-implantation as part of the continuation of therapy.
  
  
  CONCLUSIONS
  To overcome the issue of treatment continuation in the case of disulfiram therapy, which may be ceased due to frequently encountered wound complications, we believe that implantation in the subscapular intramuscular plane allows both uneventful healing and an out-of-reach implant location.
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.
authors.forename: Billur
authors.initials: B
authors.lastname: Sezgin
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Gazi University Hospital, Ankara, Turkey.
authors.forename: Serhat
authors.initials: S
authors.lastname: Sibar
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Numune Research and Training Hospital, Ankara, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Bulam
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Gazi University Hospital, Ankara, Turkey.
authors.forename: Kemal
authors.initials: K
authors.lastname: Findikcioglu
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Gazi University Hospital, Ankara, Turkey.
authors.forename: Serhan
authors.initials: S
authors.lastname: Tuncer
authors.affiliation: Department of Psychiatry, Gazi University Hospital, Ankara, Turkey.
authors.forename: Bilge
authors.initials: B
authors.lastname: Dogan
keywords: Alcoholism; Bioabsorbable implant; Disulfiram