Therapeutic Measures for Infections Originating from Scalp Incisions Following Deep Brain Stimulation in Patients with Parkinson's Disease.

Background: Deep brain stimulation (DBS) is a well-established treatment for Parkinson's disease (PD). However, infection following DBS surgery is a serious complication that can lead to the recurrence and worsening of Parkinson's symptoms or related hardware reimplantation, causing considerable patient suffering and financial burden.

Objective: This study aims to compare the therapeutic efficiency of different treatment approaches for scalp incision infections after DBS surgery in PD patients.

Methods: We conducted a retrospective review of patients with PD who experienced scalp infections following DBS at our hospital between January 2017 and December 2021. The patients were divided into 2 groups based on whether affected implants were removed or not. Fisher's exact test was applied to compare the reinfection rates between groups A and B.

Results: In group A, 4 patients underwent debridement only, and all of them experienced reinfection between 2 and 25 months after the initial treatment. In group B, 9 patients underwent debridement and removal of potentially affected implants. Among them, 8 patients underwent reimplantation of the DBS device within 3-6 months after the initial treatment, and no cases of reinfection occurred. However, 1 patient experienced reinfection in the postauricular incision and percutaneous tunnel 5 months after the initial treatment, resulting in the complete removal of the entire DBS system. The reinfection rate in group B (11.11%) was significantly lower than that in group A (100%, P = 0.007).

Conclusions: Scalp incision infections following DBS surgery can affect deep tissues, and the implementation of a comprehensive treatment strategy involving local debridement and removal of potentially affected implants can significantly reduce the risk of infection recurrence and its spread.