Rate of infection after carpal tunnel release surgery and effect of antibiotic prophylaxis.
OBJECTIVE
To determine the rate of postoperative wound infection and the association with prophylactic antibiotic use in uncomplicated carpal tunnel release surgery.


METHODS
We performed a multicenter, retrospective review of all the carpal tunnel release procedures performed between January 1, 2005, and August 30, 2007. Data reviewed included the use of prophylactic antibiotics, diabetic status, and the occurrence of postoperative wound infection. We determined the overall antibiotic usage rate and analyzed the correlation between antibiotic use and the development of postoperative wound infection.


RESULTS
The rate of surgical site infections in the 3003 patients who underwent carpal tunnel release surgery (group A) was 11. Antibiotic usage data were available for 2336 patients (group B). Six patients without prophylactic antibiotics had infection, as did 5 patients with prophylactic antibiotics. This difference was not statistically significant. Of the 11 surgical site infections, 4 were deep (organ/space) and 7 superficial (incisional). The number of patients with diabetes in the overall study population was 546, 3 of whom had infections. This was not statistically different from the nondiabetic population infection rate (8 patients).


CONCLUSIONS
The overall infection rate after carpal tunnel release surgery is low. In addition, the deep (organ/space) infection rate is much lower than previously reported. Antibiotic use did not decrease the risk of infection in this study population, including patients with diabetes. The routine use of antibiotic prophylaxis in carpal tunnel release surgery is not indicated. Surgeons should carefully consider the risks and benefits of routinely using prophylactic antibiotics in carpal tunnel release surgery.


METHODS
Therapeutic III.
Department of Orthopedic Surgery, Southern California Permanente Medical Group, Kaiser Anaheim Medical Center, Anaheim, CA 92806, USA. neil.g.harness@kp.org
Neil G
NG
Harness
Maria C
MC
Inacio
Faith F
FF
Pfeil
Liz W
LW
Paxton
D017677:Age Distribution; D000368:Aged; D019072:Antibiotic Prophylaxis; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000601:surgery*; D015331:Cohort Studies; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D016896:Treatment Outcome