Removing The Percutaneous Extension (If Applicable) - Medtronic DBS 37086 Implantationsanleitung

Figure 13. Slide boot over lead-extension connection
and tie ligatures around the ligature channels on both ends of the boot.
Note: Sterile water may be used as a lubricant for ease of placing the
boot.
Cautions:
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a. If using a winged boot, make sure the flat side of the boot lies
against the skull.
b. If using the cylindrical boot, suture it to the underlying tissue to
minimize the possibility of migration. Place this suture in the suture
channel at the proximal end of the boot covering the lead-extension
connection. Loop this suture through the underlying tissue
(periostium) to stabilize the connection.
6. For a second lead and extension, repeat steps 1 through 5.
Note: If two extensions were implanted but only one lead will be
connected, cover the unused extension with a connector boot provided
in the extension product packaging or accessory kit. Tie a ligature (using
nonabsorbable suture) around both ligature channels of the boot.
7. For instructions on making the extension-neurostimulator connection,
refer to the appropriate neurostimulator manual.

Removing the percutaneous extension (if applicable)

If a percutaneous extension was used for test stimulation at lead implant,
follow these steps to remove the percutaneous extension.
For each implanted lead:
1. Withdraw the external segment of the percutaneous extension
approximately 1 cm (0.4 in) from where it exits the skin (Figure 14).
16 English 37086 2020-01-01
Do not use polypropylene suture material on silicone
components. Polypropylene may damage the component,
resulting in component failure and surgical replacement.
Do not tie ligatures around the lead or extension body, which
may damage the insulation. Damaging the insulation can result
in loss of stimulation and component failure, which would
require surgical replacement.
Do not overtighten ligatures on the connector boot. Ligatures
that are too tight may damage the component, which would
require surgical replacement.
Ensure that the end of the connector boot is secure to prevent
fluid in the lead-extension connection, which may result in
stimulation at the connection site, intermittent stimulation, or
loss of stimulation.