Cephalosporins in Hand Surgery

Verma, Manisha; Shah, Apurva S.; Jebson, Peter J.L.

doi:10.1016/j.jhsa.2009.02.001

Cited by 3 publications

(4 citation statements)

References 32 publications

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“…Patients were followed up at 2-and 4-week intervals after the index operation. Because surgical wound infection is most likely to present during this time, 8,16 the search was limited to all records within the 30-day postoperative period. Office visit, inpatient, and emergency room records were reviewed for the presence of superficial or deep infection.…”

Section: Methodsmentioning

confidence: 99%

Is Antibiotic Prophylaxis Necessary in Elective Soft Tissue Hand Surgery?

Tosti¹,

Fowler²,

Dwyer³

et al. 2012

Orthopedics

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Antibiotic prophylaxis for clean soft tissue hand surgery is not yet defined. Current literature focuses on overall orthopedic procedures, traumatic hand surgery, and carpal tunnel release. However, a paucity of data exists regarding the role of antibiotic prophylaxis in a broader variety of soft tissue hand procedures. The goal of the current study was to evaluate the rates of surgical site infection following elective soft tissue hand surgery with respect to administration of prophylactic antibiotics.A multicenter, retrospective review was performed on 600 consecutive elective soft tissue hand procedures. Procedures with concomitant implant or incomplete records were excluded. Antibiotic delivery was given at the discretion of the attending surgeon. Patient comorbidities were recorded. Outcomes were measured by the presence of deep or superficial infections within 30 days postoperatively. The 4 most common procedures were carpal tunnel release, trigger finger release, mass excision, and first dorsal compartment release. The overall infection rate was 0.66%. All infections were considered superficial, and none required surgical management. In patients who received antibiotic prophylaxis (n=212), the infection rate was 0.47%. In those who did not receive prophylaxis (n=388), the infection rate was 0.77%. These differences were not statistically significant (P=1.00).

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Section: Methodsmentioning

confidence: 99%

Is Antibiotic Prophylaxis Necessary in Elective Soft Tissue Hand Surgery?

Tosti¹,

Fowler²,

Dwyer³

et al. 2012

Orthopedics

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show abstract

“…For the purposes of this study, this time horizon was set as it is unlikely for patients to suffer infection beyond this time frame. [23][24][25] Patients were subsequently grouped into those anesthetized with WALANT versus MAC. In the WALANT group, all cases were conducted with the use of 1% lidocaine with 1:100 000 epinephrine (buffered with 10 mL lidocaine/epinephrine:1 mL of 8.4% sodium bicarbonate).…”

Section: Methodsmentioning

confidence: 99%

“…For the purposes of this study, this time horizon was set as it is unlikely for patients to suffer infection beyond this time frame. 23-25…”

Section: Methodsmentioning

confidence: 99%

What Is the Infection Rate of Carpal Tunnel Syndrome and Trigger Finger Release Performed Under Wide-Awake Anesthesia?

Rellán

Victorica

Figueira

et al. 2021

Hand (New York, N,Y.)

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Background High infection rates have been reported in hand procedures using the wide-awake local anesthesia no tourniquet (WALANT) method, causing some to question the validity of this approach. However, little evidence exists surrounding the direct use of WALANT compared with monitored anesthetic care (MAC). This study was conducted to directly compare the postoperative infection rates of carpal tunnel syndrome (CTS) and trigger finger (TF) release surgeries performed under WALANT and MAC. Methods A retrospective study comparing postoperative infection rates between patients undergoing CTS and TR releases was conducted. Our primary outcome measure was postoperative infection. Our secondary outcome was postoperative complications. Comparative statistics were used to compare means of infection between the groups. Results A total of 526 patients underwent CTS release (255 with WALANT and 271 with MAC), and 129 patients underwent TF release (64 with WALANT and 65 with MAC). Patients undergoing WALANT and MAC were statistically comparable in terms of sex, smoking status, diabetes, and American Society of Anesthesiologists physical status classification. In patients undergoing CTS release, there were no infections with WALANT and 6 infections (2.2%) with MAC. In patients undergoing TF release, there were no infections in either group. There were similar rates of complications in patients undergoing WALANT and MAC for CTS and TF releases. Conclusion There was no increased risk of infection with WALANT compared with MAC in CTS or TR surgeries. These surgeries can be safely conducted with lidocaine and epinephrine without a concern for increased risk of infections or complications.

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“…Development of microbial resistance patterns 16 and adverse side-effects [17][18][19][20] are known risks of use of antibiotics. Antibiotics also increase the cost of medical procedures.…”

Section: My Current Conceptsmentioning

confidence: 99%

Perioperative Antibiotics for Carpal Tunnel Surgery

Szabo

2010

The Journal of Hand Surgery

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Cephalosporins in Hand Surgery

Cited by 3 publications

References 32 publications

Is Antibiotic Prophylaxis Necessary in Elective Soft Tissue Hand Surgery?

Is Antibiotic Prophylaxis Necessary in Elective Soft Tissue Hand Surgery?

What Is the Infection Rate of Carpal Tunnel Syndrome and Trigger Finger Release Performed Under Wide-Awake Anesthesia?

Perioperative Antibiotics for Carpal Tunnel Surgery

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