A prospective trial on the use of antibiotics in hand surgery.
BACKGROUND
Postoperative infection is a disastrous complication in the discipline of hand surgery, as it is in any field of surgery in which infection can compromise wound healing and lead to subsequent functional impairment despite the best attempts. Different results with antibiotic use by different authors have been reported. This study was planned to put forth the place of antibiotic use in hand surgery procedures.


METHODS
This prospective, randomized, double-blind study included 1340 patients who were placed in one of four groups according to the components of their hands that were injured. Half of each group received antibiotics, and the other half received placebo.


RESULTS
Infections among the placebo- and antibiotic-administered patients did not display significant importance (p=0.759). Infections among the four groups were not statistically significant either (p=0.947). Statistical significance was not found between elective and emergency procedures (p=0.552). Operations longer than 2 hours had 2.5 percent infection rates in placebo patients and 3.8 percent in antibiotic patients, which was not statistically significant (p=0.7). In crush/dirty wounds there was no statistical significance in development of infections between placebo and antibiotic use (p=1), nor was there any statistically significant difference between crush and dirty wounds (p=0.929).


CONCLUSIONS
The authors do not support the use of antibiotic prophylaxis for surgery of the hand. Its use should be preserved for specific infections or for patients with certain types of risk factors for infection.
Aydin
Nihal
N
Ankara, Turkey From the Second Department of Plastic and Reconstructive Surgery, Ankara Numune Training and Research Hospital.
Uraloğlu
Muhammed
M
Burhanoğlu
Asu Deniz Yilmaz
ADY
Sensöz
Ömer
Ö
D000328:Adult; D019072:Antibiotic Prophylaxis; D002437:Cefazolin / Q000008:administration & dosage; D004311:Double-Blind Method; D005260:Female; D006225:Hand / Q000601:surgery*; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D011300:Preoperative Care; D013530:Surgical Wound Infection / Q000517:prevention & control*
D002437:Cefazolin