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

From the West Midlands Regional Plastic Surgery Unit, Wordsley Hospital, Stourbridge, West Midlands, UK

Correspondence: Dr J.P. Whittaker, Sunnybank, 99 Harwoods Lane, Rossett, Flintshire, LL12 OEU, UK. Tel.: +44 78980 689 405. E-mail: jpwhittaker{at}onetel.net.uk

A prospective, randomized, double blind, placebo controlled trial was designed to investigate the effect of prophylactic flucloxacillin on the infection rate in clean incised hand injuries, which included trauma to skin, tendon and nerve in adults. Using strict exclusion criteria, a total of 170 patients were recruited into one of three trial groups; Group A – intravenous flucloxacillin on induction followed by an oral placebo; Group B – intravenous flucloxacillin on induction followed by an oral flucloxacillin course or Group C – oral placebo. Thirteen of the patients were subsequently withdrawn, leaving 92% available to complete the trial. Infection was diagnosed using clinical criteria. The infection rates in the three groups were Group A – 13%, Group B – 4% and Group C – 15%. Strictly, the results demonstrate no statistically significant difference in the infection rates between the groups.

Key Words: hand • infection • injury • prophylactic antibiotics

Journal of Hand Surgery (British and European Volume), Vol. 30, No. 2, 162-167 (2005)
DOI: 10.1016/J.JHSB.2004.10.015


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