Traumatic wound breakdown following bahaa™ implant

Objectives: -To highlight the importance of recognizing and managing severe peri-operative and post-operative soft tissue complications of baha™ osseointegrated implants. -To discuss a patient with severe post-traumatic peri-operative and post-operative scalp complications following baha™ surgery, including management options. Study Design: -Case report and literature review of post-operative soft tissue complications of baha™ osseointegrated implants. Methods (Case Summary): -A patient presented with a severe right sided mixed hearing loss and was treated with a baha™ osseointegrated implant. -Post-operatively, the patient suffered trauma to the site and developed a severe traumatic wound infection, with complete dehiscence of the split thickness skin graft. -The patient was treated with oral antibiotics and meticulous, aggressive local wound care. Operative management was considered but not implemented. -Full healing with ability to use the device successfully was achieved. Results: -The patient healed completely and did not require revision surgery. He now has serviceable hearing after benefiting from the baha™ implant. Conclusions: - Although post-operative complications following baha™ surgery are infrequent and commonly mild, the surgeon will rarely be encountered by a severe soft tissue complication as described. Aggressive local wound care included culture-guided antibiotic therapy is indicated prior to performing revision surgery.