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ATB prophylaxis in hand surgery, Sweden - Coggle Diagram
ATB prophylaxis in hand surgery, Sweden
in Sweden
Adherence to evidence-based measures to reduce surgical site infections, including proper antibiotic prophylaxis timing and hand hygiene, is suboptimal in orthopedic surgery in Sweden.anderson et al 2012
prevalence
The prevalence of superficial surgical site infection in hand surgery in Sweden is 6.25%. Bhandari et al 2023
Infection rates of just over 1% were observed in day-case hand surgery in Sweden. Hashemi et al 2004
The paper discusses collaboration between orthopaedic surgeons and infection specialists in treating bone and joint infections in Sweden, but does not specifically address surgical infection site in hand surgery. Hedström et al 2019
elective hand surgery
Antibiotic prophylaxis does not reduce surgical site infection rates in clean, elective hand surgeries under 30 minutes, even in high-risk patients.Vasconcelos et al 2017, Tosti et al 2012, Bykowski et al 201 Bäcker et al 2019 Li et al 2018
open hand trauma surgery
Postoperative antibiotic prophylaxis is not indicated for open hand trauma surgery, as the surgical site infection rate is low without it.Héri et al 2021
1 day vs 3-5 days
1 day (cf reviews Vanvelk et al 2022, Messner et al 2017, Chang et al 2015) no difference in the infection rate when a longer duration of antibiotics (three to five days) was compared with a shorter duration (one day) (risk ratio = 0.97; 95% confidence interval, 0.69 to 1.37)
debated
The use of routine antibiotic prophylaxis in hand surgery is controversial, with some evidence supporting it and some opposing it. Dunn et al 2018
The role of prophylactic antibiotics for small, clean, elective hand surgery procedures lasting less than 2 hours is debated. Eberlin et al 2015
The role of prophylactic antibiotics in elective hand surgery is not well-defined in the current literature. Rizvi et al 2008
The efficacy of antibiotic prophylaxis versus placebo or no treatment on wound infection rates in surgically managed hand injuries is assessed. Murphy et al 2016
Preoperative antibiotics did not reduce minor infection rates but caused adverse reactions in clean hand surgery.Kistler et al 2023
Risk of SSI
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Outside the OR
Some types of hand surgery may be done outside the operating theatre without increasing the risk of infection.Jagodzinski et al 2017
Inside the OR
The timing of antibiotic prophylaxis is associated with the risk of surgical site infections, with the lowest risk when antibiotics are given within 30 minutes prior to incision. Steinberg et al 2009
Intraoperative corticosteroid injections at the surgical site increase the risk of surgical site infections for hand procedures. Lutsky et al 2019
Using a strict pin site management protocol adapted from the Ilizarov method reduces the incidence of pin site infection in hand and wrist surgery. Solari et al 2021
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