Do silver-impregnated dressings limit infections after lumbar laminectomy with instrumented fusion?

Abstract

BACKGROUND:

Silver has been used to reduce infection for centuries. This study retrospectively analyzed whether the introduction of silver-impregnated dressing (SD; Silverlon, Argentum Medical, LLC, Lakefront, GA) rather than RD (iodine- or alcohol-based swab and dry 4 x 4 gauze) would reduce the risk of superficial or deep infection after lumbar laminectomy with instrumented fusion.

METHODS:

The first 128 patients had RD applied postoperatively, whereas the second population of 106 patients received SD. These dressings were used for the first 2 weeks after surgery. Other clinical, surgical, and outcome data were comparable for both groups.

RESULTS:

Three of 128 patients who underwent multilevel laminectomies with instrumented fusions receiving RD developed deep postoperative wound infections (culture confirmed). All were successfully managed with 6 weeks of postoperative antibiotics, and none required secondary surgery. In addition, 11 patients who had RD developed superficial infection/irritation; 7 required oral antibiotics (7-10 days) alone, whereas 4 were referred to plastic surgeons for superficial wound revision. Alternatively, there were neither deep nor superficial wound infections/irritation among the 106 patients who received SD. Although the number of cases in each series was small, there appeared to be a positive trend toward a reduction in postoperative wound infection using SD.

CONCLUSIONS:

Use of SD for application on lumbar wounds after laminectomies with instrumented fusions appeared to limit/reduce the incidence of both postoperative deep and superficial wound infections.

• Authors: Nancy E Epstein
• Journal: Surgical neurology (Surg Neurol) Vol. 68 Issue 5 Pg. 483-5; discussion 485 (Nov 2007) ISSN: 0090-3019 [Print] United States
• PMID: 17961738 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• silverlon
• Silver

Topics

• Adult
• Aged
• Bandages
• Cohort Studies
• Female
• Humans
• Laminectomy (adverse effects)
• Lumbar Vertebrae (surgery)
• Male
• Middle Aged
• Retrospective Studies
• Silver (therapeutic use)
• Spinal Fusion (adverse effects, instrumentation)
• Surgical Wound Infection (etiology, prevention & control)
• Treatment Outcome