Assessing the Impact of Antibiotic Prophylaxis in Outpatient Elective Hand Surgery: A Single-Center, Retrospective Review of 8,850 Cases

Surgical site infection in hand surgery

“…Multivariable logistic regression modeling was used to identify factors associated with development of SSI after hand surgery. Besides sociodemographic characteristics, we included diabetes and tobacco use in our model, as they have been previously suggested as predictors of SSI in the hand surgery setting [19]. We also considered obesity because it has been associated with higher risk for SSI following other orthopaedic procedures [27,15].…”

“…This discrepancy in rates might be partly explained by the fact that Harness and colleagues did not exclude patients undergoing more than one hand surgery procedure simultaneously. Recently, Bykowski et al [19] reviewed their institutional experience with carpal tunnel surgery and found a SSI rate of 0.24 %. Their infection rate could be lower than ours because their follow-up period was shorter (79 vs. 90 days), those patients with SSI seeking care at a different institution were not counted, and the examination of the surgical wound was performed by the original surgeon who might be less inclined to diagnose SSI [19].…”

“…Recently, Bykowski et al [19] reviewed their institutional experience with carpal tunnel surgery and found a SSI rate of 0.24 %. Their infection rate could be lower than ours because their follow-up period was shorter (79 vs. 90 days), those patients with SSI seeking care at a different institution were not counted, and the examination of the surgical wound was performed by the original surgeon who might be less inclined to diagnose SSI [19]. We found that 0.20 % of patients undergoing trigger finger release developed SSIs that led to an acute care visit, which is considerably lower than the 2.0 % infection rate reported by Bruijnzeel et al [31] in their ten-year institutional review of 1,598 trigger finger releases.…”

“…A recent population-based study by Owens et al [6] emphasized that SSIs are also common after ambulatory surgery. Hand surgery is common, but there is limited research about the incidence and correlates of SSI in this setting [19][20][21][22]. The available data are mainly derived from single institutions, focus exclusively on one procedure (e.g.…”

“…The available data are mainly derived from single institutions, focus exclusively on one procedure (e.g. carpal tunnel release), and do not contain enough infections to conduct meaningful statistical analysis [19][20][21][22]. Given that even seemingly trivial SSIs following hand surgery can have important clinical and economic consequences [4,[23][24][25], a better understanding of their incidence and associated factors might prove useful for better allocation of resources and implementation of preventive strategies.…”