The Role of Antibiotic Prophylaxis in Clean Incised Hand Injuries: A Prospective Randomized Placebo Controlled Double Blind Trial

Author(s): Whittaker JP, Nancarrow JD, Sterne GD.

Source: J Hand Surg 30B:162-167, 2005.

Summary:

The authors investigate the effect of prophylactic flucloxacillin on the infection rate in clean incised hand injuries, which included trauma to skin, tendon and/or nerve.  One-hundred and seventy adult patients with such injuries were recruited into 1 of 3 groups; Group A – intravenous flucloxacillin at surgery followed by oral placebo; Group B – intravenous flucloxacillin at surgery followed by a short course of oral flucloxacillin; Group C – oral placebo.  The authors found no statistically significant difference in the infection rates between groups (Group A – 13%, Group B – 4%, and group C – 15%).

The role of antibiotic prophylaxis in clean incised injuries of the hand remains unclear.  The results of this study showed a lower rate of infection in patients receiving both intravenous and oral flucloxacillin following injury.  However, this possible trend was not statistically significant (p > 0.05).  As the authors concluded, a further study using the same definitions for wound infection and greater patient numbers may help to delineate whether a true and significant difference exists.      

 

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J Hand Surg