Literature DB >> 31042430

Carpal tunnel decompression in primary care: what is the infection risk and is it safe and effective?

V Palial1, A Kheiran2, S Siddiqui1.   

Abstract

INTRODUCTION: The demand for elective hand surgery in England is predicted to double by 2030 compared with 2011. With such increase in demand, the UK must seek strategies to reduce costs of treatment while still maintaining standards of care. Carpal tunnel decompression performed in a treatment room rather than in theatre may provide a safe alternative setting. As yet, there are no UK-based studies that identify the risk of infection following surgery performed in a treatment room and there are no studies whatsoever assessing the qualitative outcomes of patients undergoing hand surgery outside a theatre environment. Our aim was to assess whether carpal tunnel decompression performed in the community is safe, in terms of infection risk, and effective.
MATERIALS AND METHODS: Patient outcome measures were prospectively recorded following carpal tunnel decompression in one single primary care centre performed by one surgeon from 2012 to 2017. Infection following surgery was evaluated for retrospectively.
RESULTS: A total of 460 patients underwent carpal tunnel decompression within the study time period. There were three superficial infections identified, giving an infection rate of 0.65%. There were no deep infections identified. There was a statistically significant improvement in both symptom and functional outcomes following surgery, with results comparable to other studies where surgery was performed in theatre. DISCUSSION: We believe that carpal tunnel decompressions performed in a treatment room is both safe, in terms of infection risk, and effective. Surgeons should consider this location as an alternative setting to the main operating theatre.

Entities:  

Keywords:  Carpal tunnel decompression; Carpal tunnel syndrome

Mesh:

Year:  2019        PMID: 31042430      PMCID: PMC6513365          DOI: 10.1308/rcsann.2019.0036

Source DB:  PubMed          Journal:  Ann R Coll Surg Engl        ISSN: 0035-8843            Impact factor:   1.891


  9 in total

1.  Guidelines on the facilities required for minor surgical procedures and minimal access interventions.

Authors:  H Humphreys; J E Coia; A Stacey; M Thomas; A-M Belli; P Hoffman; P Jenks; C A Mackintosh
Journal:  J Hosp Infect       Date:  2011-12-20       Impact factor: 3.926

2.  A detailed cost and efficiency analysis of performing carpal tunnel surgery in the main operating room versus the ambulatory setting in Canada.

Authors:  Martin R Leblanc; Janice Lalonde; Donald H Lalonde
Journal:  Hand (N Y)       Date:  2007-05-30

3.  Rate of infection after carpal tunnel release surgery and effect of antibiotic prophylaxis.

Authors:  Neil G Harness; Maria C Inacio; Faith F Pfeil; Liz W Paxton
Journal:  J Hand Surg Am       Date:  2010-02       Impact factor: 2.230

4.  Incidence of common compressive neuropathies in primary care.

Authors:  R Latinovic; M C Gulliford; R A C Hughes
Journal:  J Neurol Neurosurg Psychiatry       Date:  2006-02       Impact factor: 10.154

5.  A one-stop carpal tunnel clinic.

Authors:  M J Reid; L A David; J E Nicholl
Journal:  Ann R Coll Surg Engl       Date:  2009-02-13       Impact factor: 1.891

6.  Patient-Related Risk Factors for Infection Following Open Carpal Tunnel Release: An Analysis of Over 450,000 Medicare Patients.

Authors:  Brian C Werner; Victor A Teran; D Nicole Deal
Journal:  J Hand Surg Am       Date:  2017-10-18       Impact factor: 2.230

Review 7.  A systematic review of the psychometric properties of the Boston Carpal Tunnel Questionnaire.

Authors:  Jose C de Carvalho Leite; Christina Jerosch-Herold; Fujian Song
Journal:  BMC Musculoskelet Disord       Date:  2006-10-20       Impact factor: 2.362

8.  Linear regression analysis of Hospital Episode Statistics predicts a large increase in demand for elective hand surgery in England.

Authors:  Emily Bebbington; Dominic Furniss
Journal:  J Plast Reconstr Aesthet Surg       Date:  2014-10-16       Impact factor: 2.740

Review 9.  Carpal tunnel syndrome.

Authors:  Somaiah Aroori; Roy A J Spence
Journal:  Ulster Med J       Date:  2008-01
  9 in total

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