Surg Neurol
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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. ⋯ 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.
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Conventional laminectomy is a simple procedure that provides adequate decompression in cases of lumbar spinal canal stenosis. However, with this surgical modality, important posterior osteoligamentous elements necessary for spinal stability are lost; and it is often accompanied by damage to the facet joint. Bilateral interlaminar fenestration and unroofing of the intervertebral foramen to achieve decompression of the nerve roots by using a unilateral microsurgical approach in lumbar spinal canal stenosis are less invasive compared with conventional laminectomy. ⋯ This unilateral, minimally invasive decompression provided satisfactory results.
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Case Reports
Successful surgical treatment of a hemophiliac infant with nontraumatic acute subdural hematoma.
The moderate hemophiliacs usually have no spontaneous bleeding, but bleed after minor or major trauma. The proper management of intracranial hemorrhage in hemophiliac children is a challenge. ⋯ The possibility of intracranial hemorrhage in a moderate hemophiliac infant should be considered even if the patient has no history of trauma. The surgical treatment results in a successful outcome in hemophiliac children with subdural hematomas provided that an aggressive factor replacement therapy is initiated before surgery.