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. (Plast. Reconstr. Surg. 126: 1617, 2010.)