Open AccessDo We Require to Use Antibacterial Prophylaxis in Hand Trauma? Results of a Randomised Prospective Case-Control Trial
Author(s) -
Dzintars Ozols,
Vadims Ņefjodovs,
Jānis Zariņš,
Aigars Pētersons
Publication year - 2021
Publication title -
proceedings of the latvian academy of sciences. section b, natural sciences/latvijas zinātņu akadēmijas vēstis. a daļa, humanitārās un sociālās zinātnes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.168
H-Index - 9
eISSN - 2255-890X
pISSN - 1407-009X
DOI - 10.2478/prolas-2021-0019
Subject(s) - medicine , incidence (geometry) , antibiotics , surgery , prospective cohort study , debridement (dental) , wound care , saline , randomized controlled trial , anesthesia , physics , microbiology and biotechnology , optics , biology
The proper management of traumatic hand injury is crucial for wound infection prevention. Antibiotics in various forms and conditions are prescribed to avoid this complication, but the effectiveness is unclear. Most forms used are intravenous solutions, topical ointments, and oral tablets. This prospective case-control trial was conducted in a tertiary care hospital. Healthy adult patients with simple, non-bite, surgically treated hand wounds were included. During the surgery, a proper debridement and irrigation with simple saline was consistently performed. Patients were randomly assigned to one of the eight groups. Seven groups received different antibacterial prophylaxis and one received none. At the two-week postoperative follow-up the wound site was assessed and any local infection was documented. Patients were excluded from the trial if they did not comply to treatment recommendations (i.e. commence antibiotics, applied solutions or ointments on the wound). Overall, 240 patients (80.2% male, mean age 38.7 years), 30 in each study group were included. 226 patients returned for the follow-up, and seven patients were excluded from the trial. Wound infection was observed in five patients from different groups. Thus, the rate of wound infection was 2.28%. A Chi-square test revealed no difference in infection incidence between the groups (p > 0.05). In this study, antibiotics did not affect incidence of wound infection after hand trauma. Attention should be paid to proper debridement and irrigation of the wound as these interventions reduce the risk for wound infection and avoid unnecessary usage of antibiotics.