Concomitant use of computer image guidance, linear or sigmoid incisions after minimal shave, and liquid wound dressing with XXXX for @entity5 craniotomy or craniectomy: analysis of 225 consecutive surgical cases with antecedent historical control at one institution.

@entity5 @entity1 @entity21079
OBJECTIVE: Recent neurosurgical literature reflects rapidly evolving, technically enhanced methods that promise to improve neurosurgical outcomes. We review our experience with computer image guidance, linear or sigmoid incisions after minimal shaving, and liquid wound dressing with @entity21079 (Dermabond; Ethicon, Inc., Somerville, NJ) for @entity5 craniotomy or craniectomy in our attempt to optimize craniotomy or craniectomy for @entity5 . METHODS: After institutional review board approval, we retrospectively reviewed @entity1 who underwent craniotomy or craniectomy for @entity5 with or without the combination of techniques specified above. A prior cohort of @entity1 who underwent craniotomy or craniectomy with traditional techniques served as a retrospective basis of comparison. Analysis included in- and outpatient chart reviews, which included the operative notes, pathology reports, discharge summaries, outpatient office records, and intraoperative nursing records. Data were entered into a statistical spreadsheet for analysis and comparison. RESULTS: A total of 225 consecutive @entity1 underwent a combination of less invasive techniques from July 2000 through October 2001. These @entity1 were matched with 225 @entity1 in a standard neurosurgical cohort that included @entity1 who underwent operations from July 1994 through July 2000. Age, @entity5 type, radiation, reoperation rate, @entity5 location, and extent of resection were comparable for both groups. The overall wound complication rate was significantly lower in the minimally invasive group when compared with the control cohort of @entity1 (0.9% versus 6.2%; P = 0.0298), even for early follow-up (0.9% versus 3.5%; P = 0.0427). Pedicle flap design was a variable that was significantly associated with wound complication. CONCLUSION: Modern neurosurgical techniques are beneficial for @entity1 undergoing craniotomy or craniectomy for @entity5 and seem to be superior to standard techniques. Although the study is multifactorial and retrospective, this conclusion is further supported by the enhanced self-image @entity1 have during the postoperative period.
