Our Summary

This study looked at whether giving antibiotics before wrist arthroscopy surgery (a procedure where a tiny camera is inserted into the wrist to diagnose or treat various conditions) helps to prevent infections. The researchers looked back at 576 wrist arthroscopy surgeries conducted over a 10-year period.

In some of these cases (about 65%), the patient was given antibiotics before the surgery. In the rest of the cases (about 35%), the patient didn’t receive any antibiotics before the surgery. The researchers found that infections occurred in only 0.6% of all cases. Interestingly, the two patients who did develop infections had received antibiotics before their surgery.

Based on these findings, the researchers concluded that giving antibiotics before wrist arthroscopy does not seem to reduce the risk of infections from the surgery. The chance of getting an infection from this type of surgery is already very low, whether a patient receives antibiotics beforehand or not. Therefore, this study suggests that it may be okay to not give antibiotics before surgeries that already have a very low risk of infection.

FAQs

  1. Does taking antibiotics before wrist arthroscopy surgery help to prevent infections?
  2. What percentage of patients given antibiotics before wrist arthroscopy developed infections?
  3. What is the overall infection rate for wrist arthroscopy surgeries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about wrist arthroscopy is that the risk of infection from the surgery is already very low, and giving antibiotics before the procedure may not necessarily reduce this risk. It’s important to follow post-operative care instructions, keep the incision site clean and dry, and watch for any signs of infection such as increased pain, redness, swelling, or drainage. If any concerning symptoms develop, it’s important to contact your healthcare provider immediately.

Suitable For

Patients who are typically recommended wrist arthroscopy include those with conditions such as carpal tunnel syndrome, ligament tears, arthritis, ganglion cysts, wrist fractures, or chronic wrist pain that has not responded to other treatments. These patients may benefit from wrist arthroscopy to diagnose the cause of their symptoms or to perform minimally invasive procedures to treat their condition.

Timeline

Before wrist arthroscopy:

  1. Patient is evaluated by a healthcare provider and diagnosed with a wrist condition that requires arthroscopy.
  2. Surgery is scheduled and patient is informed about the procedure, risks, and benefits.
  3. Patient may be prescribed antibiotics to take before the surgery, depending on the healthcare provider’s recommendation.

After wrist arthroscopy:

  1. Patient undergoes wrist arthroscopy surgery, where a tiny camera is inserted into the wrist to diagnose or treat the condition.
  2. Patient is monitored in the recovery room and may be discharged the same day or kept overnight for observation.
  3. Patient is given post-operative instructions, including information on pain management, wound care, and physical therapy.
  4. Patient follows up with the healthcare provider for a post-operative check-up to monitor healing and recovery.
  5. Patient resumes normal activities gradually as advised by the healthcare provider, with the goal of improving wrist function and reducing pain.

What to Ask Your Doctor

Some questions a patient should ask their doctor about wrist arthroscopy in light of this study include:

  1. What is the typical infection rate for wrist arthroscopy surgeries?
  2. What are the potential risks and benefits of taking antibiotics before wrist arthroscopy?
  3. Are there any specific factors that would make me more or less likely to benefit from antibiotic prophylaxis before the surgery?
  4. Are there alternative methods or precautions that can be taken to reduce the risk of infection without antibiotics?
  5. Can we discuss the possibility of not taking antibiotics before the surgery based on the low infection rate found in this study?
  6. What is the standard protocol for antibiotic use before wrist arthroscopy at this facility, and can we discuss any potential modifications based on this new research?
  7. What steps will be taken during the surgery to minimize the risk of infection?
  8. How will I be monitored for any signs of infection after the surgery?
  9. What should I do if I suspect that I may have developed an infection after the surgery?
  10. Are there any other recent studies or guidelines that we should consider when making decisions about antibiotic use for wrist arthroscopy?

Reference

Authors: Hoel RJ, Mittelsteadt MJ, Samborski SA, Bohn DC. Journal: J Hand Surg Am. 2018 Nov;43(11):987-991.e1. doi: 10.1016/j.jhsa.2018.03.040. Epub 2018 May 16. PMID: 29778348