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Effects of Postoperative Oral Corticosteroids on Infection Rates in Upper Extremity Surgery.

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Hand (New York, N.Y.)
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Summary

Postoperative oral corticosteroids are safe for adult upper extremity surgery and do not increase surgical site infection (SSI) risk. This 6-day low-dose regimen shows comparable SSI rates to controls, supporting its use.

Keywords:
diagnosishand surgeryinfectionmethylprednisoloneoral corticosteroidsupper extremity surgery

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Area of Science:

  • Orthopedic Surgery
  • Pharmacology
  • Infectious Disease

Background:

  • Postoperative oral corticosteroids are increasingly used for pain and outcomes in hand/upper extremity surgery.
  • Concerns exist about increased infection risk, but evidence is lacking.
  • This study investigates the safety of a specific corticosteroid regimen regarding surgical site infections (SSIs).

Purpose of the Study:

  • To evaluate if a 6-day regimen of low-dose postoperative oral corticosteroids increases the risk of surgical site infections (SSIs) in adult upper extremity surgeries.
  • To assess the safety and efficacy of this treatment protocol.

Main Methods:

  • Retrospective analysis of 813 adult patients undergoing clean upper extremity surgery (Nov 2021-Nov 2023).
  • Comparison of SSI rates at 14 and 30 days between patients receiving a 6-day course of methylprednisolone and those who did not.
  • Statistical analysis using chi-squared and Wilcoxon rank-sum tests.

Main Results:

  • No statistically significant difference in SSI rates between the corticosteroid group (4.1%) and the control group (3.1%).
  • Analysis included 196 patients on steroids and 617 controls.
  • Subgroup analysis revealed no demographic or comorbidity differences in patients who developed SSIs.

Conclusions:

  • Low-dose, 6-day postoperative oral corticosteroid use is safe for adult upper extremity surgery.
  • This regimen does not elevate the risk of surgical site infections.
  • Further prospective studies are recommended to confirm these findings.