Justine S Ko1, Samantha Zwiebel1, Brigid Wilson2, Devra B Becker3. 1. Case Western Reserve University School of Medicine, 2109 Adelbert Rd, Cleveland, OH, 44106, USA. 2. Geriatric Research, Education and Clinical Center, Louis Stokes VA Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA. 3. Department of Plastic Surgery, Louis Stokes VA Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA. Electronic address: devra.becker@uhhospitals.org.
Abstract
PURPOSE: Carpal tunnel syndrome (CTS) has a high incidence in diabetic patients, with a reported incidence up to 21%. In severe cases of CTS, patients may undergo carpal tunnel release (CTR) surgery, which involves the risk of infection and other complications. To decrease the risk of infection, some physicians provide prophylactic antibiotics. Our study examines the effects of prophylactic antibiotic use, especially in a high-risk, diabetic population. METHODS: A total of 469 CTR surgeries performed by plastic surgery specialists were reviewed for diabetic status at the time of surgery and perioperative antibiotic use. Postoperative infections occurring at the surgical site were recorded. Associations between perioperative antibiotic use and infection in diabetics and nondiabetics were then analyzed. RESULTS: No significant decrease in infection rate was seen in those who were given perioperative antibiotic use. This relationship held true for diabetics as well. CONCLUSIONS: No benefit of antibiotic use during CTR surgery was seen. There was, however, a trend toward a protective effect in patients with uncontrolled diabetes mellitus, suggesting that such patients may benefit from perioperative antibiotic use. LEVEL OF EVIDENCE: III (Retrospective cohort study), Therapeutic. Published by Elsevier Ltd.
PURPOSE:Carpal tunnel syndrome (CTS) has a high incidence in diabeticpatients, with a reported incidence up to 21%. In severe cases of CTS, patients may undergo carpal tunnel release (CTR) surgery, which involves the risk of infection and other complications. To decrease the risk of infection, some physicians provide prophylactic antibiotics. Our study examines the effects of prophylactic antibiotic use, especially in a high-risk, diabetic population. METHODS: A total of 469 CTR surgeries performed by plastic surgery specialists were reviewed for diabetic status at the time of surgery and perioperative antibiotic use. Postoperative infections occurring at the surgical site were recorded. Associations between perioperative antibiotic use and infection in diabetics and nondiabetics were then analyzed. RESULTS: No significant decrease in infection rate was seen in those who were given perioperative antibiotic use. This relationship held true for diabetics as well. CONCLUSIONS: No benefit of antibiotic use during CTR surgery was seen. There was, however, a trend toward a protective effect in patients with uncontrolled diabetes mellitus, suggesting that such patients may benefit from perioperative antibiotic use. LEVEL OF EVIDENCE: III (Retrospective cohort study), Therapeutic. Published by Elsevier Ltd.