Download PDF
Open Access
CC BY 4.0 · Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Surgery 2025; 40: s00451812094
DOI: 10.1055/s-0045-1812094
Artigo Original

Efficacy of Prophylactic Antibiotics in Preventing Surgical Site Infection in Cases of Hand Injuries

Article in several languages: português | English

Authors

  • Manjunath Kalapurmatt 

    1   Departamento de Cirurgia Plástic, Ramaiah Medical College, Ramaiah University of Applied Sciences, Bangalore, Karnataka, Índia

  • Durga Sowgandhi Chilikuri 

    1   Departamento de Cirurgia Plástic, Ramaiah Medical College, Ramaiah University of Applied Sciences, Bangalore, Karnataka, Índia

  • Sunmathi Parasuramulu 

    1   Departamento de Cirurgia Plástic, Ramaiah Medical College, Ramaiah University of Applied Sciences, Bangalore, Karnataka, Índia

  • Venkatesh Mysore Srinivasa 

    1   Departamento de Cirurgia Plástic, Ramaiah Medical College, Ramaiah University of Applied Sciences, Bangalore, Karnataka, Índia


Financial Support The authors declare that they did not receive financial support from agencies in the public, private, or non-profit sectors to conduct the present study. Clinical Trials None.
Further Information
  Permissions and Reprints

Abstract

Introduction

Traumatic hand injuries are common in plastic surgery. Surgical site infections (SSIs) are the most common preventable complication following surgery, and the most common nosocomial infection. In the few studies that directly assess SSI in hand and wrist trauma, the risk ranges from 3 to 10%, rates similar to those reported for all operative procedures. But there are increasing concerns regarding the inadvertent use of antibiotics, as well as an increasing incidence of antibiotic resistance. The efficacy of prophylactic antibiotics in preventing infection is questionable. Hence, we have decided to conduct the present study.

Materials and Methods

Patients admitted with hand injury between June 1st, 2022, and June 31st, 2024, were included. The patients who received prophylactic antibiotics (1 dose within 60 minutes of the incision) and those who did not were divided into 2 groups. In the follow-up records, we checked for signs of infection or for the evidence of SSI in both groups, and its statistical significance was analyzed.

Results

Among the 216 patients with hand injuries analyzed, 116 received prophylactic antibiotics (group A) and 100 did not (group NA). A total of 1.7 % of group A and 1% of group NA developed SSIs, but this was not statistically significant.

Conclusion

In terms of demographics, younger people are disproportionately affected by hand injuries; however they present fewer comorbidities and high vascularity, which are advantageous for wound healing and resistance to SSI. The variables of the surgical procedures, such as the use of implants and surgery duration, have fewer implications for the incidence of postoperative SSI.

Keywords

antibiotic prophylaxis - drug resistance, multiple - hand injuries - prostheses and implants - surgical wound infection

Ethical Committee Approval

Study has been approved by the institutional ethics committee under number NO-MSRMC/EC/AP-02/03-24.


Authors' Contributions

MK: study conception and design, methodology, and writing – original draft; SC: study conception and design, data collection, and investigation; SR: study conception and design, analysis and/or interpretation of data, and writing – review & editing;; and VMS: study conception and design, and final approval of the manuscript.




Publication History

Received: 08 January 2025

Accepted: 18 August 2025

Article published online:
27 October 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil

Bibliographical Record
Manjunath Kalapurmatt, Durga Sowgandhi Chilikuri, Sunmathi Parasuramulu, Venkatesh Mysore Srinivasa. Eficácia de antibióticos profiláticos na prevenção de infecção pós-operatória e infecção do sítio cirúrgico em casos de lesões na mão. Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Surgery 2025; 40: s00451812094.
DOI: 10.1055/s-0045-1812094
 

  • Referências

  • 1 Centers for Disease Control and Prevention (CDC). National Healthcare Safety Network (NHSN). NHSN Patient Safety Component Manual. Atlanta: CDC; 2025. Available from: https://www.cdc.gov/nhsn/pdfs/pscmanual/pcsmanual_current.pdf
  • 2 Bucataru A, Balasoiu M, Ghenea AE, Zlatian OM, Vulcanescu DD, Horhat FG. et al. Factors Contributing to Surgical Site Infections: A Comprehensive Systematic Review of Etiology and Risk Factors. Clin Pract 2023; 14 (01) 52-68 10.3390/clinpract14010006
    Search in Google Scholar
  • 3 Baldwin AJ, Jackowski A, Jamal A, Vaz J, Rodrigues JN, Tyler M. et al. Risk of surgical site infection in hand trauma, and the impact of the SARS-CoV-2 pandemic: A cohort study. J Plast Reconstr Aesthet Surg 2021; 74 (11) 3080-3086 10.1016/j.bjps.2021.06.016
    Search in Google Scholar
  • 4 National Institute for Health and Care Excellence (NICE). Surgical site infections: prevention and treatment. NICE Guideline 125. London: NICE; 2020 . Available from: https://www.nice.org.uk/guidance/ng125/resources/surgical-site-infections-prevention-and-treatment-pdf-66141660564421
  • 5 Shapiro LM, Zhuang T, Li K, Kamal RN. The use of preoperative antibiotics in elective soft-tissue procedures in the hand: a critical analysis review. JBJS Rev 2019; 7 (08) e6 10.2106/JBJS.RVW.18.00168
    Search in Google Scholar
  • 6 Wukich DK. Diabetes and its negative impact on outcomes in orthopaedic surgery. World J Orthop 2015; 6 (03) 331-339
    Search in Google Scholar
  • 7 Li K, Sambare TD, Jiang SY, Shearer EJ, Douglass NP, Kamal RN. Effectiveness of preoperative antibiotics in preventing surgical site infection after common soft tissue procedures of the hand. Clin Orthop Relat Res 2018; 476 (04) 664-673
    Search in Google Scholar
  • 8 Ansari S, Hassan M, Barry HD, Bhatti TA, Hussain SZM, Jabeen S, Fareed S. Risk Factors Associated with Surgical Site Infections: A Retrospective Report from a Developing Country. Cureus 2019; 11 (06) e4801 10.7759/cureus.4801
    Search in Google Scholar
  • 9 Bhandari PS, Nakarmi K, Chaurasia LR, Pudasini P. Superficial Surgical Site Infection in Hand Surgery: A Cross-sectional Study in a Hand Surgery Unit. JIOM Nepal 2023; 45 (02) 41-44 10.59779/jiomnepal.1266
    Search in Google Scholar
  • 10 Bäcker HC, Freibott CE, Wilbur D, Tang P, Barth R, Strauch RJ. et al. Prospective Analysis of Hand Infection Rates in Elective Soft Tissue Procedures of the Hand: The Role of Preoperative Antibiotics. Hand (N Y) 2021; 16 (01) 81-85 10.1177/1558944719842238
    Search in Google Scholar
  • 11 World Health Organization (WHO). . Global Action Plan on Antimicrobial Resistance. Geneva: WHO; 2015 . Available from: https://www.who.int/publications/i/item/9789241509763
  • 12 Sandrowski K, Edelman D, Rivlin M, Jones C, Wang M, Gallant G, Beredjiklian PK. A Prospective Evaluation of Adverse Reactions to Single-Dose Intravenous Antibiotic Prophylaxis During Outpatient Hand Surgery. Hand (N Y) 2020; 15 (01) 41-44 10.1177/1558944718787264
    Search in Google Scholar
  • 13 Kistler JM, Munn M, McEntee R, Ilyas AM. Antibiotic Prophylaxis in Clean Hand Surgery: A Prospective Cohort Analysis of Major and Minor Complications. J Hand Surg Glob Online 2023; 5 (04) 421-425 10.1016/j.jhsg.2023.03.011
    Search in Google Scholar
  • 14 Murphy GRF, Gardiner MD, Glass GE, Kreis IA, Jain A, Hettiaratchy S. Meta-analysis of antibiotics for simple hand injuries requiring surgery. Br J Surg 2016; 103 (05) 487-492 10.1002/bjs.10111
    Search in Google Scholar
  • 15 Ketonis C, Dwyer J, Ilyas AM. Timing of debridement and infection rates in open fractures of the hand. Hand (N Y) 2017; 12 (02) 119-126 10.1177/1558944716643294
    Search in Google Scholar
  • 16 Davies J, Roberts T, Limb R, Mather D, Thornton D, Wade RG. Time to surgery for open hand injuries and the risk of surgical site infection: a prospective multicentre cohort study. J Hand Surg Eur Vol 2020; 45 (06) 622-628 10.1177/1753193420905205
    Search in Google Scholar
  • 17 Dunn JC, Means Jr KR, Desale S, Giladi AM. Antibiotic Use in Hand Surgery: Surgeon Decision Making and Adherence to Available Evidence. Hand (N Y) 2020; 15 (04) 534-541 10.1177/1558944718812161
    Search in Google Scholar
  • 18 Lipira AB, Sood RF, Tatman PD, Davis JI, Morrison SD, Ko JH. Complications within 30 days of hand surgery: an analysis of 10,646 patients. J Hand Surg Am 2015; 40 (09) 1852-1859.e3 10.1016/j.jhsa.2015.06.103
    Search in Google Scholar
  • 19 Tosti R, Fowler J, Dwyer J, Maltenfort M, Thoder JJ, Ilyas AM. Is antibiotic prophylaxis necessary in elective soft tissue hand surgery?. Orthopedics 2012; 35 (06) e829-e833 10.3928/01477447-20120525-20
    Search in Google Scholar
  • 20 Aydin N, Uraloğlu M, Burhanoğlu ADY, Sensöz Ö. A prospective trial on the use of antibiotics in hand surgery. Plast Reconstr Surg 2010; 126 (05) 1617-1623 10.1097/PRS.0b013e3181ef90cb
    Search in Google Scholar