The Use of Prophylactic Antibiotics in Surgery for Dupuytren's Disease: A Survey of Hand Surgeons.

Abstract

BACKGROUNDNational Institute for Health and Care Excellence (NICE) CG74 has set out evidence-based guidance on which types of surgery require antibiotic prophylaxis. Our aim was to establish what the current practice for antibiotic prophylaxis in Dupuytren’s surgery is amongst hand surgeons in the United Kingdom, through the British Society for Surgery of the Hand (BSSH). METHODSPermission was granted for our online survey to be distributed to BSSH hand surgeons via consecutive BSSH e-bulletins. Hand surgeons who did not perform fasciectomy or dermofasciectomy were excluded from the study. RESULTSThere were 64 respondents, represented an estimated 7.4-7.8% of membership. Eleven percent of respondents used antibiotics for fasciectomy, with an increasing trend towards revision surgery and dermofasciectomy. Over 30% prescribed them for revision dermofasciectomy. Dupuytren’s surgery was classified as clean, non-prosthetic and uncomplicated which NICE CG74 suggestions did not require antibiotic prophylaxis. CONCLUSIONThis study highlighted variation in practice amongst hand surgeons in the United Kingdom. Further consultation to create guidelines for hand surgery may help guide members and reduce potentially unnecessary prophylactic antibiotic use.