J Mangwani1, A Gulati2, R Benson3, M Cichero4, D M Williamson5. 1. Consultant in Trauma and Orthopaedics, University Hospitals of Leicester, NHS Trust, UK. Electronic address: jmangwani@hotmail.com. 2. Specialist Registrar in Trauma and Orthopaedics, University Hospitals of Leicester NHS Trust, UK. Electronic address: gulatiaashish@doctors.org.uk. 3. Consultant in Trauma and Orthopaedic Surgery, Maidstone and Tunbridge Wells NHS Trust, UK. 4. Consultant Podiatrist-Podiatric Surgeon, Great Western Hospital, Swindon and Marlborough NHS Trust, UK. 5. Consultant in Trauma and Orthopaedics, Great Western Hospital, Swindon and Marlborough NHS Trust, UK.
Abstract
BACKGROUND: This prospective randomised controlled trial was performed to determine whether the incidence of local infection is reduced in patients who are administered prophylactic antibiotics for lesser toe fusion surgery. METHODS:100 adult patients undergoing toe fusion surgery that required K-wires to be left in situ for 4-6 weeks were randomly allocated into those who received prophylactic antibiotics (Group 1, n=48) and those who did not (Group 2, n=52). Patients were followed up regularly and during each visit K-wire insertion sites were assessed for signs of pin tract infection. RESULTS: The mean age of Group 1 was 58.0 (SD 17.5) and Group 2 was 62.7 years (SD 14.7). The overall infection rate was 4%. Three patients (6.2%) in Group 1 and one patient (1.9%) in Group 2 developed signs of infection, which required treatment by oral antibiotics. All infections were low grade. There were no features suggestive of osteomyelitis in any of the patients. CONCLUSION: The overall infection rate in lesser toe fusion surgery is low and that using prophylactic antibiotics does not reduce the incidence. Inappropriate use of antibiotics, however, may contribute to the development of antibiotic resistance and adds to healthcare costs.
RCT Entities:
BACKGROUND: This prospective randomised controlled trial was performed to determine whether the incidence of local infection is reduced in patients who are administered prophylactic antibiotics for lesser toe fusion surgery. METHODS: 100 adult patients undergoing toe fusion surgery that required K-wires to be left in situ for 4-6 weeks were randomly allocated into those who received prophylactic antibiotics (Group 1, n=48) and those who did not (Group 2, n=52). Patients were followed up regularly and during each visit K-wire insertion sites were assessed for signs of pin tract infection. RESULTS: The mean age of Group 1 was 58.0 (SD 17.5) and Group 2 was 62.7 years (SD 14.7). The overall infection rate was 4%. Three patients (6.2%) in Group 1 and one patient (1.9%) in Group 2 developed signs of infection, which required treatment by oral antibiotics. All infections were low grade. There were no features suggestive of osteomyelitis in any of the patients. CONCLUSION: The overall infection rate in lesser toe fusion surgery is low and that using prophylactic antibiotics does not reduce the incidence. Inappropriate use of antibiotics, however, may contribute to the development of antibiotic resistance and adds to healthcare costs.
Authors: Mr Ravi Krishān Modha; Chris Morriss-Roberts; Madeleine Smither; Jonathan Larholt; Ian Reilly Journal: J Foot Ankle Res Date: 2018-11-15 Impact factor: 2.303