A 30-year-old man with a background of cerebral palsy and spastic diplegia had a right flank ITB pump inserted 7 years previously. During a routine follow-up clinic, the ITB pump was visibly protruding through the subcutaneous tissue of the abdominal wall (Fig. 2). This complication occurred following a period of significant weight loss after his recent move to university. Otherwise, the patient was apyrexial and there was no erythema, purulent discharge or raised temperature in the skin. WBC and CRP were normal.
Six days later, the patient underwent a re-siting procedure. The old transverse wound was opened and the original pump was dissected from its capsule. It was then inserted into the potential space developed between the superior rectus abdominus and the posterior rectus sheath. The pump was anchored to the posterior rectus sheath with polyester suture. A new proximal catheter was attached to the pump and brought out superficial to the superficial linea alba, where it was connected to the old distal catheter using a straight connector (Fig. 3). The wound was closed in layers.
The patient was monitored in the ITB pump clinic, where he received regular refills. Twelve months later, the pump was stable and the wound remained intact.