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CC BY-NC-ND 4.0 · Revista Iberoamericana de Cirugía de la Mano 2017; 45(02): 089-093
DOI: 10.1055/s-0037-1608625
Original Article | Artículo Original
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Antibiotic Prophylaxis in Elective Hand Surgery

Profilaxis antibiótica en cirugía electiva de la mano
Carolina Vasconcelos
1   Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Plastic, Reconstructive and Maxillo-Facial Surgery, Hospital de Egas Moniz, Lisboa, Portugal
,
Marta Serra
1   Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Plastic, Reconstructive and Maxillo-Facial Surgery, Hospital de Egas Moniz, Lisboa, Portugal
,
Rúben Nogueira
1   Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Plastic, Reconstructive and Maxillo-Facial Surgery, Hospital de Egas Moniz, Lisboa, Portugal
,
Leonor do Carmo
1   Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Plastic, Reconstructive and Maxillo-Facial Surgery, Hospital de Egas Moniz, Lisboa, Portugal
› Author Affiliations
Further Information

Publication History

11 June 2017

25 September 2017

Publication Date:
06 November 2017 (online)

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Abstract

Purpose Antibiotic prophylaxis decreases the rate of surgical site infection in a broad spectrum of surgical procedures. However, in patients undergoing elective hand surgery, there is evidence of lower efficacy, and its use might be related to the development of antimicrobial resistance. The side effects and higher health-related costs must also be taken into consideration. Our aim was to assess the efficacy of antibiotic prophylaxis in these procedures.

Material and methods A retrospective study was conducted including all patients who underwent clean, elective hand surgery lasting less than 30 minutes from January 1st 2014 to December 31st 2015 at our hospital. The demographic and surgery-related data were analyzed using the Statistical Package for the Social Sciences (SPSS, IBM Corp., Armonk, NY, US) software, version 23.0.

Results A total of 346 patients matched the study's inclusion criteria. The infection rate was of 1%, and it was not influenced by gender, age or diabetes mellitus. Antibiotic prophylaxis was administered in 52% of the cases, and it had no effect on the decrease in the infection rate, even in the group of diabetic patients.

Conclusions Despite the inherent limitations of any retrospective study, our data analysis supports the fact that prophylactic antibiotic administration does not reduce the incidence of surgical site infection in clean, elective hand surgery that lasts less than 30 minutes, even in patients at risk.

Resumen

Introducción La profilaxis antibiótica disminuye la tasa de infección quirúrgica en un amplio espectro de procedimientos. Sin embargo, en los pacientes sometidos a cirugía electiva de la mano, existe evidencia de una menor eficacia, y hay que considerar que su uso podría estar relacionado con el desarrollo de la resistencia a los antimicrobianos, los efectos secundarios y el mayor costo en salud. Nuestro objetivo fue evaluar la eficacia de la profilaxis antibiótica en estos procedimientos.

Material y métodos Se realizó un estudio retrospectivo que incluyó a todos los pacientes sometidos a cirugía de mano limpia y programada, con duración inferior a 30 minutos, desde el 1 de enero de 2014 al 31 de diciembre de 2015 en nuestro hospital. Los datos demográficos y quirúrgicos se analizaron mediante el programa Statistical Package for the Social Sciences (SPSS, IBM Corp., Armonk, NY, US), versión 23.0.

Resultados Un total de 346 pacientes cumplió los criterios de inclusión en el estudio. La tasa de infección fue de 1%, y no fue influenciada por el sexo, la edad, o diabetes mellitus. La profilaxis antibiótica se administró en el 52% de los casos, y no tuvo efecto sobre la disminución de la tasa de infección, incluso en el grupo de pacientes diabéticos.

Conclusiones A pesar de las limitaciones inherentes a cualquier estudio retrospectivo, nuestro análisis de datos apoya el hecho de que la administración profiláctica de antibióticos no reduce la incidencia de infección del sitio quirúrgico en cirugía de mano limpia y programada, con duración inferior a 30 minutos, incluso en pacientes de riesgo.

Keywords

hand surgery - antibiotic prophylaxis - infection

Palabras Clave

cirúgia de mano - profilaxis antibiótica - infección
 

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