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OBJECTIVE: To analyze the influence of head positioning during preoperative image data acquisition on intraoperative accuracy of modern neuronavigation systems. MATERIAL AND METHODS: All measurements were performed preoperatively before opening the head. In 24 patients, preoperative MR image data acquisition was performed twice on a 0.5 T scanner using a contrast-enhanced T1-weighted sequence; first in the neutral head position, and thereafter in the surgical head position for pterional craniotomy. For both data sets, the Sylvian fissure, the central sulcus, and the superior and inferior temporal sulci were depicted on the patient's scalp using the frameless neuronavigation system EasyGuide Neurotrade mark. At the beginning of surgery, with the head fixed in a Mayfield clamp and an articulated instrument holder being used for fixation of the navigation system's pointer, the distances of 10 correlating points of the sulci for the two data sets were measured. To evaluate the accuracy of the navigation system in this experimental set-up, a phantom study was also performed. RESULTS: The phantom study revealed a mean inaccuracy of 1.6 mm (range 0.1-2.3 mm, standard deviation 0.6 mm). The patient study revealed a mean inaccuracy of 1.8 mm (range 0.4-2.8 mm, standard deviation 0.5 mm). CONCLUSIONS: The data suggest that the positioning of the patient's head during preoperative imaging plays no relevant role in intraoperative accuracy of neuronavigation. However, further studies and a larger number of patients with various pathologies in different regions of the brain are necessary to obtain a better understanding of the problem of brain shift in neuronavigation due to patient positioning alone, and to avoid procedure-related operative morbidity.

Die antiseptische und antimikrobielle Wirkung von Silber wird schon seit dem Altertum zur Wundbehandlung genützt. Noch in den Sechzigerjahren des 20 Jahrhunderts wurde Silbernitrat zur Behandlung von Brandwunden verbreitet eingesetzt. Wenig später jedoch durch die, in ihrer Handhabung, bessere[for full text, please go to the a.m. URL], 30. Jahrestagung der Deutschsprachigen Arbeitsgemeinschaft für Verbrennungsbehandlung (DAV 2012)

Hintergrund: Die Vakuumtherapie (Vacuum Assisted Closure - Therapy - VAC) zur Wundheilung ist ein nichtinvasives, geschlossenes System. Mittels einer Pumpe wird ein kontrollierter, örtlich begrenzter negativer Druck in einer Wunde erzeugt und dadurch der Heilungsprozess sowohl in den chronischen[for full text, please go to the a.m. URL], DAV 2011; 29. Jahrestagung der Deutschsprachigen Arbeitsgemeinschaft für Verbrennungsbehandlung