Foregoing Preoperative Antibiotics in Clean, Implant-Based Hand Surgery Does Not Increase Postoperative Infectious...

Area of Science:

• Orthopedic Surgery
• Infectious Disease
• Hand Surgery

Background:

• Preoperative antibiotic use is standard for many surgical procedures.
• Evidence supporting the omission of preoperative antibiotics exists for outpatient soft-tissue procedures.
• Limited data address antibiotic use for implant-based hand surgeries.

Purpose of the Study:

• To evaluate early postoperative infectious complications in patients undergoing implant-based hand surgery.
• To determine if withholding preoperative antibiotics impacts the need for postoperative antibiotics or reoperation for infection.

Main Methods:

• Retrospective cohort analysis of 1,394 implant-based hand procedures (January 2015 - October 2021).
• Primary outcomes: antibiotic prescription or reoperation for infection within 90 days.
• Covariate balancing and weighted logistic regression used to compare outcomes between patients who received and did not receive preoperative antibiotics.

Main Results:

• 16.9% of patients did not receive preoperative antibiotics.
• No significant difference in 30-day or 90-day postoperative antibiotic prescription rates between groups.
• Patients not receiving preoperative antibiotics showed no significantly higher odds of requiring postoperative antibiotics.
• Male gender, temporary Kirschner wire fixation, and elevated BMI predicted increased postoperative antibiotic use.

Conclusions:

• Withholding preoperative antibiotics for implant-based hand procedures does not elevate the risk of postoperative infection or need for antibiotics.
• Findings suggest that preoperative antibiotic use may not be necessary for all patients undergoing these specific procedures.