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Preoperative Antibiotics in Wrist Arthroscopy
Ryan J Hoel1, Marcus J Mittelsteadt1, S Andrew Samborski2
1Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN.
The Journal of Hand Surgery
|May 21, 2018
Summary
Preoperative antibiotics are not necessary for routine wrist arthroscopy, as they do not reduce surgical site infection rates. The infection rate is very low, making it acceptable to withhold antibiotics in such procedures.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Prevention
- Surgical Site Infections
Background:
- Surgical site infections (SSIs) are a concern in orthopedic procedures.
- Prophylactic antibiotic use is standard for many surgeries, but its necessity in low-risk procedures is debated.
Purpose of the Study:
- To evaluate the necessity of preoperative antibiotics in preventing surgical site infections (SSIs) after wrist arthroscopy.
- To determine if withholding preoperative antibiotics impacts infection rates in wrist arthroscopy.
Main Methods:
- Retrospective review of 576 wrist arthroscopies over 10 years.
- Infection diagnosis based on National Nosocomial Infections Surveillance criteria.
- Analysis of antibiotic administration and concomitant procedures.
Main Results:
- 324 patients met inclusion criteria; 209 received preoperative antibiotics (65%), 115 did not (35%).
- Overall infection rate was 0.6% (2 cases).
- Both infections occurred in patients who received preoperative antibiotics and underwent concomitant procedures.
Conclusions:
- Preoperative antibiotics do not appear to lower the surgical site infection rate in routine wrist arthroscopy.
- The extremely low infection rate prevents determining a significant difference between antibiotic and non-antibiotic groups.
- Withholding preoperative antibiotics is acceptable for low-risk procedures like wrist arthroscopy.
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