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Peri-operative Antibiotic Prophylaxis in K-Wire Fixation: A Systematic Review and Meta-analysis.

Ahmad Abul¹, Mohammad Karam², Shaima Al-Shammari²

¹Division of Surgical and Interventional Sciences, University College London, Gower Street, London, WC1E 6BT UK.

Indian Journal of Orthopaedics

|June 29, 2023

Summary

Prophylactic antibiotics are not significantly different from no antibiotics for preventing surgical site infections (SSI) in patients undergoing Kirschner wire (K-wire) fixation for orthopaedic surgery. This finding applies to both trauma and elective procedures.

Keywords:

Antibiotic prophylaxis Infection rate K-wires

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Area of Science:

Orthopaedic Surgery
Infectious Disease Prevention
Evidence-Based Medicine

Background:

Standardized guidelines are lacking regarding antibiotic prophylaxis for Kirschner wire (K-wire) fixation in clean orthopaedic surgery.
Minimizing the risk of surgical site infection (SSI) is a primary concern in orthopaedic procedures utilizing K-wires.

Purpose of the Study:

To compare the incidence of SSIs between patients receiving antibiotic prophylaxis and those not receiving antibiotics during K-wire fixation.
To evaluate outcomes in both trauma and elective orthopaedic surgery contexts.

Main Methods:

A systematic review and meta-analysis were conducted following PRISMA guidelines.
Included studies comprised randomized controlled trials (RCTs) and non-randomized studies.
The primary outcome measure was the incidence of surgical site infection (SSI).

Main Results:

A total of five studies (one RCT, four retrospective cohort studies) involving 2316 patients were analyzed.
No statistically significant difference in SSI incidence was observed between the prophylactic antibiotic group and the no-antibiotic group (OR = 0.72, P = 0.18).
The findings were consistent across trauma and elective orthopaedic surgery cases.

Conclusions:

Peri-operative antibiotic administration does not show a significant benefit in reducing SSIs for patients undergoing orthopaedic surgery with K-wire fixation.
Current evidence suggests that routine antibiotic prophylaxis may not be necessary for K-wire procedures in clean orthopaedic surgery.