TECHNICAL NOTE - FUNCTIONAL A sine-wave-shaped skin incision for inserting deep-brain stimulators Bilgehan Solmaz & Necati Tatarlı & Davut Ceylan & Yaşar Bayri & M. İbrahim Ziyal & Aşkın Şeker Received: 13 April 2014 /Accepted: 30 April 2014 # Springer-Verlag Wien 2014 Abstract Background The sine-wave-shaped skin incision is a tech- nique that minimizes skin-related complications near burr hole caps after electrode placement for deep-brain stimulation (DBS). Methods Between 2011 and 2013, 54 DBS electrodes were implanted in 27 consecutive patients with Parkinson’ s disease (PD), essential tremor, or dystonia. The sine-wave incision was used in 26 patients and conventional bilateral linear scalp incisions were used in one patient. Results None of the patients whose operations involved sine- wave-shaped incisions developed hardware-linked complica- tions such as skin infection or skin erosion. The one patient who underwent conventional bilateral linear scalp incisions developed a skin infection. Conclusion By preserving the vascular anatomy of the scalp and reducing skin tension at the wound site, the sine-wave- shaped incision promotes wound healing. Keywords Deep-brain stimulation . Scalp incision . Neurosurgery . Surgical technique . Wound healing Introduction Deep-brain stimulation (DBS) is a surgical method commonly used to treat Parkinson’ s disease (PD), dystonia, essential tremor, chronic pain, and some psychiatric disorders [4]. Some skin incisions that surgeons currently use to place the electrodes (implants) for DBS can lead to complications. Such problems include infection and skin erosions that may neces- sitate removal of DBS implants, and this is especially unfor- tunate when a patient is experiencing clinical improvement after successful targeting procedures. This article describes our experience with a sine-wave- shaped skin incision for inserting DBS implants. Methods Between July 2011 and July 2013, 54 DBS electrodes were implanted in 27 patients at Marmara University Institute of Neurological Sciences, Turkey. Twenty-two patients had PD, three had dystonia, and two had essential tremor. Convention- al bilateral linear scalp incisions were used in the first patient. After this patient developed a skin infection, we used the sine- wave-shaped incision (see technique description below) for the remaining 26 patients. Informed consent was obtained from all patients prior to the procedures. Surgical technique for sine-wave-shaped incision Ceftriaxone 2.0 g is administered intravenously 30 minutes before the skin incision is made. After fixing the frame to the patient’ s head, obtaining magnetic resonance images, and B. Solmaz Department of Neurosurgery, Istanbul Education and Research Hospital, Istanbul, Turkey N. Tatarlı Department of Neurosurgery, Dr.Lütfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey N. Tatarlı : Y. Bayri : M. İ. Ziyal : A. Şeker (*) Institute of Neurological Sciences, Marmara University, Marmara Üniversitesi Nörolojik Bilimler Enstitüsü, P.K.53 Başıbüyük-Maltepe, 34840 İstanbul, Turkey e-mail: askinseker@hotmail.com D. Ceylan Department of Neurosurgery, Sakarya University School of Medicine, Sakarya, Turkey Y. Bayri : M. İ. Ziyal : A. Şeker Department of Neurosurgery, Marmara University School of Medicine, Istanbul, Turkey Acta Neurochir DOI 10.1007/s00701-014-2123-8