AI Article Synopsis
- The study aimed to evaluate the effectiveness and safety of using prophylactic antibiotics in clean hand surgeries, focusing on both major and minor infection rates as well as adverse effects from the antibiotics.
- It involved a cohort of 377 patients who underwent upper extremity surgeries, comparing those who received preoperative antibiotics with those who did not over a 6-month period.
- Findings showed a minor infection rate of 5.6% with no major infections, but the use of antibiotics led to a 6.9% rate of complications, suggesting that the benefits of prophylactic antibiotics are unclear and caution is advised in their use.
Article Abstract
Purpose: The indications for prophylactic antibiotics in hand surgery remain undefined. Current literature has focused solely on readmission and reoperation for surgical site infection, while neglecting minor infectious complications treated at outpatient follow-up in addition to complications from antibiotic therapy observed after surgery. This study sought to analyze major and minor infection rates, as well as adverse effects of preoperative antibiotics after clean hand surgery.
Methods: A prospective cohort study was conducted over a 6-month period. The cohorts included patients who received preoperative antibiotic prophylaxis and those that did not. Patient details and operative data were obtained during the first postoperative visit following the index surgery. Primary outcomes assessed were as follows: (1) major infection, defined as admission or reoperation for infection; (2) minor infection, defined as use of postoperative oral antibiotics; and (3) complications of antibiotic therapy.
Results: A total of 377 consecutive patients underwent operations of the upper extremity. Complications from preoperative antibiotic therapy were seen in 6.9% of patients. Overall, there were no major postoperative infections and the minor postoperative infection rate was 5.6%. The minor infection rate was 6.9% (9/131) among patients who did not receive preoperative antibiotics and 4.9% (12/246) among patients who received preoperative antibiotics ( = .57).
Conclusions: A 5.6% minor infection rate was identified following clean hand surgery, with no cases of major infection. Preoperative antibiotics did not demonstrate benefit in terms of reduction of minor infections, but they did yield a 6.9% adverse reaction rate, including one case of infection warranting hospitalization. Caution is recommended while prescribing prophylactic antibiotics for clean hand surgeries, given the lack of clear benefits and the potential for adverse effects.
Type Of Study/level Of Evidence: Prognostic II.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382872 | PMC |
| http://dx.doi.org/10.1016/j.jhsg.2023.03.011 | DOI Listing |
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