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Prophylactic antibiotics in open distal phalanx fractures: systematic review and meta-analysis

D Metcalfe1, A L Aquilina2, H M Hedley2

  • 1University Hospital Coventry & Warwickshire, Coventry, UK Harvard Medical School, Boston, MA, USA d.metcalfe@doctors.org.uk.

The Journal of Hand Surgery, European Volume
|September 3, 2015
PubMed

Insights

Prophylactic antibiotics do not significantly reduce superficial infections in open distal phalanx fractures. Prompt wound care, including irrigation and debridement, is recommended over antibiotic use.

Area of Science:

  • Orthopedic Surgery
  • Infectious Disease Prevention
  • Trauma Care

Background:

  • Open distal phalanx fractures are susceptible to infection.
  • The role of prophylactic antibiotics in preventing these infections is debated.

Purpose of the Study:

  • To systematically review evidence on the efficacy of prophylactic antibiotics in reducing infection rates after open distal phalanx fractures.

Main Methods:

  • Systematic review and meta-analysis of four randomized controlled trials.
  • Inclusion of 353 fractures, with a focus on superficial infection and osteomyelitis rates.

Main Results:

  • No statistically significant difference in superficial infection rates between antibiotic and non-antibiotic groups.
  • No cases of osteomyelitis were reported in the pooled data, even in the non-antibiotic group.

Conclusions:

  • Prophylactic antibiotics show no demonstrable benefit in preventing superficial infections following open distal phalanx fractures.
  • Emphasis should be placed on thorough irrigation and debridement for wound management.
Keywords:
Distal phalanxantibioticsopen fracture

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