Please login to view this media
- Talk
- 21/09/2022
- UK
Time to Surgery for Open Hand Injuries and the Risk of Surgical Site Infection: A Prospective Multi Centre Cohort Study
Description
In this detailed presentation, Richard Limb, a member of the Mersey trainees, discusses a significant research study they conducted examining the impact of surgical intervention timing on infection rates in hand injuries. Limb highlights the importance of this research due to the commonality and high cost of hand injuries, which often require surgical intervention and antibiotic treatment. The study addresses critical questions about whether the timing of surgery and the use of preoperative antibiotics affect the rates of surgical site infections (SSI).
He outlines the study's design, a prospective multicenter cohort study over 12 months, which included adults with unilateral hand injuries requiring surgery. Various factors, including patient demographics, injury specifics, and timing, were systematically collected and analyzed. Limb emphasizes that prior studies often had shortcomings such as small sample sizes and arbitrary time frame classifications.
The findings reveal that surgical timing—up to 90 hours—did not significantly influence infection rates. Instead, skin loss appeared as an independent risk factor for SSI. Furthermore, the study concluded that preoperative antibiotics did not effectively reduce infection rates, even in high-risk scenarios such as diabetic patients or severe crush injuries.
Richard Limb's discussion covers implications for clinical practice, suggesting that surgeons can prioritize cases without the fear of significantly increasing infection risks if surgeries are delayed for up to four days. The audience, including Donald Campbell, poses questions about potential changes in policy and specific antibiotic practices, to which Limb responds by clarifying that the study’s design did not focus on altering antibiotic use but rather on timing's role in surgical intervention.