Reexamining the need for antibiotic prophylaxis in pediatric upper extremity surgery

Area of Science:

• Orthopedic Surgery
• Pediatric Surgery
• Infectious Disease

Background:

• Recent literature questions routine antibiotic prophylaxis in adult clean surgeries.
• Consensus is lacking on the necessity of antibiotic prophylaxis for pediatric upper extremity and hand procedures.

Purpose of the Study:

• To investigate if antibiotic prophylaxis affects postoperative surgical site infection (SSI) rates in pediatric upper extremity (UE) procedures.

Main Methods:

• Retrospective review of pediatric patients undergoing clean UE surgery (Nov 2021-Nov 2023).
• Primary outcomes: SSI diagnosis at 14 and 30 days.
• Statistical analysis included Chi-square, Fisher's exact, and Wilcoxon rank-sum tests (p < 0.05 significant).

Main Results:

• 396 pediatric patients analyzed; 217 received preoperative antibiotics, 179 did not.
• SSI rates were 0.9% in the antibiotic group and 1.1% in the no-antibiotic group.
• No statistically significant difference in SSI rates (p = 0.846).

Conclusions:

• Findings challenge the necessity of preoperative antibiotics in pediatric UE surgery.
• No statistical difference in SSI rates observed regardless of antibiotic prophylaxis.
• Further randomized controlled trials with larger populations are recommended to confirm these findings.