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

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.