Prophylactic antibodies in elective hand surgery do not lower SSI rates
A retrospective chart review of 1,067 elective hand surgery procedures has indicated a low rate of surgical site infections (SSIs), with most being superficial wound infections, underscoring a trend that the use of prophylactic antibiotics does not lead to a decreased risk of surgical site infection.
Katharine Criner and colleagues in Philadelphia, USA, reviewed the complete charts of adult patients with more than two weeks of postoperative follow-up who underwent elective hand surgery performed by six hand surgeons at a single institution. In addition to grouping patients according to whether they received prophylactic antibiotics in the operating theatre, the researchers further categorised patients based on whether they underwent soft tissue procedures or surgery that involved implantation or work on the bone or joints. There were 390 patients who had surgery using implants or involving the bone or joints and received antibiotics and 248 patients in this subgroup who did not. Overall, the study population had a mean age of 47 years and there was no significant differences in demographics between the antibiotics and no antibiotics group.
Reporting at the American Academy of Orthopaedic Surgeons annual meeting at Las Vegas in March, Criner revealed that the overall infection rate for the whole study population was 2.8%, with the majority of wound infections being superficial. The superficial infection rate was 2.1%, deep infection rate was 0.7% and soft tissue infection rate was 1.4%; the infection rate in patients who had bone and joint work or implants used was 3.8%. “Prophylactic antibiotics did not decrease the rate of postoperative infections for our entire study population,” said Ccriner.” However our main study weakness, in addition to being retrospective in nature, is that in terms of our bone, joint and implant subgroup, it was underpowered so it is purely just a trend that prophylactic antibiotics did not decrease the risk of infection in this subgroup.”