Gunshot Wounds to the Upper Extremity.

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Abstract

[Indexed for MEDLINE] 13. Hand Surg Rehabil. 2024 Sep;43(4):101753. doi: 10.1016/j.hansur.2024.101753. Epub 2024 Jul 26. Antibiotic prophylaxis in surgery for closed fracture of the hand. Lidauer K(1), Helenius I(2), Pääkkönen M(3). Author information: (1)Department of Hand and Upper Limb Surgery, Diseases of the Musculoskeletal System Division, Turku University Hospital, University of Turku and CoE TYKS ORTO, Turku, Finland. Electronic address: kjlida@utu.fi. (2)Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Paediatric Surgery, Orthopaedics and Traumatology, University of Turku and Turku University Hospital, Turku, Finland. (3)Department of Hand and Upper Limb Surgery, Diseases of the Musculoskeletal System Division, Turku University Hospital, University of Turku and CoE TYKS ORTO, Turku, Finland. PURPOSE: Preoperative antibiotic prophylaxis is associated to internal fixation for closed phalangeal and metacarpal fracture, but its effectiveness is not known. METHODS: In a consecutive series of 119 adult patients undergoing Kirschner-wire fixation for phalangeal or metacarpal fracture, 56.3% (n = 67) received antibiotic prophylaxis and 43.7% (n = 52) did not. RESULTS: The rate of deep surgical site infection was 1.5% (n = 1) in the group with antibiotic prophylaxis and 1.9% (n = 1) in the group without. Minor skin irritation or infection of the pin tract occurred in 13.4% of cases (n = 9) in the group with antibiotic prophylaxis and 9.6% (n = 5) in the group without. CONCLUSION: Our findings suggest that use of antibiotic prophylaxis could be reduced in the treatment of closed fractures of the hand treated with removable pins. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV (retrospective review). Copyright © 2024 SFCM. Published by Elsevier Masson SAS. All rights reserved. DOI: 10.1016/j.hansur.2024.101753