title: 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.affiliation: Albert Einstein College of Medicine, Bronx, New York; Winthrop University Hospital, Mineola, New York. dch3@columbia.edu
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Epstein
mesh_terms: D000328:Adult; D000368:Aged; D001458:Bandages; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000009:adverse effects*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012834:Silver / Q000627:therapeutic use*; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: C500574:silverlon; D012834:Silver