Traumatic wound breakdown following baha™ 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.