Tabatabaei, Kevin

Background: Polyetheretherketone (PEEK) is a commonly used material for cranioplasties due to its advantages over other materials and autologous bone grafts. PEEK has an increased malleability, which increases postoperative aesthetics and adapts well to the cranial contours; it is also associated with a lower rate of infection when compared with autologous cranioplasties. Despite these benefits, there is limited information on the practical aspects of modifying PEEK cranioplasties after their initial placement. Case Series: We present 2 cases of patients who had previously undergone PEEK cranioplasty being treated with deep-brain stimulation (DBS), which was placed through their PEEK implant. The first was an 18-year-old male who had previously undergone cranial vault closure with bone grafts following a craniotomy. Later, when a deep-brain stimulator was planned, it was discovered that the bone grafts had significant resorption and a lack of structural integrity. Therefore, bone grafts were replaced with a custom PEEK implant cranioplasty before the DBS electrodes were placed via drilling through the PEEK implant to access the brain at a later surgery. The second patient was a 39-year-old male who developed epilepsy after a stroke, requiring craniotomy. DBS was unable to be performed initially due to significant resorption of the patient’s native bone. Therefore, a PEEK cranioplasty was performed in preparation for a staged, subsequent placement of DBS electrodes through the implant. Both patients recovered uneventfully following surgery, with noticeable improvement in functional (reduction in seizure frequency) and aesthetic outcomes. Systematic Review: A literature review was conducted using PubMed with keywords related to PEEK cranioplasties. After screening titles, abstracts, and full-text papers, it was found that 3 previously documented cases have involved drilling through PEEK implants: one by Mallela et al, involving SEEG electrode placement; one by Marrone et al, concerning a burr hole for evacuating a chronic subdural hematoma; and one by Ledesma et al, regarding the placement of subdural grid electrodes. Conclusions: This case series highlights how PEEK cranioplasties can be drilled through for therapeutic procedures, such as DBS electrode implantation, without compromising their structure. These cases illustrate the versatility, safety, and adaptability of PEEK implants for additional necessary interventions.

ABSTRACT The integration of Internet of Things devices in medicine has paved the way for novel diagnostic and therapeutic solutions that offer ‘smart’ capabilities, especially for at‐home wound monitoring. Such capabilities include increasing portability, diminished gaps in care through continuous analysis, and real‐time programmable manipulation of device parameters to intervene more rapidly. This scoping review explores the landscape of Internet of Things devices, including smart bandages, wearable and skin‐interfaced sensors, and mobile app‐connected devices, specifically designed for chronic wound monitoring in a remote, at‐home setting. We reviewed literature from PubMed, IEEE Xplore, Scopus, and Web of Science, using keywords related to Internet of Things and chronic wound care. The evaluation criteria focused on biomarkers analysed, Internet of Things connectivity technology, experimental models used for device validation, and unique device strengths or weaknesses. Our review identified 52 unique studies comprising 77 data entries across five biomarker categories: gas and oxygen saturation, pH, metabolic markers, biophysical parameters of the wound microenvironment, and molecular markers of inflammation or infection. These devices span a wide landscape of biomarkers analysed to predict and monitor wound recovery, with the potential to improve patient outcomes through personalised treatment and timely interventions. However, many devices were never validated clinically on humans and faced limitations in power delivery, accuracy, stability, and reliability that challenge their potential usability in humans for wound monitoring. This review provides a comprehensive understanding of the potential and limitations of Internet of Things devices in at‐home wound care, highlighting areas for future research and development.