E. Renard et al., COMPLICATIONS OF THE PUMP POCKET MAY REPRESENT A SIGNIFICANT CAUSE OFINCIDENTS WITH IMPLANTED SYSTEMS FOR INTRAPERITONEAL INSULIN DELIVERY, Diabetes care, 17(9), 1994, pp. 1064-1066
Citations number
6
Categorie Soggetti
Endocrynology & Metabolism","Medicine, General & Internal
OBJECTIVE- To increase awareness of adverse events associated with the
use of programmable implantable pumps (PIPs). CASES- There were 7 cas
es of complications associated with the pump-pocket among 40 patients
treated by PIP, and we searched for risk factors. RESULTS- Seven of 40
type I diabetic patients treated by PIP presented severe complication
s of the pump-pocket, resulting in five definitive explantations and n
ine other surgical interventions. The lesions included an exudative re
action in the pump-pocket and a skin retraction or atrophy, which were
complicated by skin erosion in five patients. Coagulase-negative stap
hylococcus was identified in the pump-pocket in four patients, includi
ng three cases of skin erosion. No specific risk of local complication
s could be attributed to age, sex, duration of diabetes, body mass ind
ex, presence of retinopathy or peripheral neuropathy, HbA(1c) level si
nce implantation, depth of implantation in the abdominal wall, or dura
tion of experience with PIP. Usual physical activity corresponding to
>2,000 kcal energy expenditure per week, estimated by a questionnaire,
appeared to be the only identified significant risk factor. CONCLUSIO
NS- From these results, we suggest that physical activity should be li
mited to moderate exercise and exclude vigorous efforts in diabetic pa
tients treated by PIP to avoid an increased risk of complications at t
he implantation site.