Should We Use Prophylactic Systemic Antibiotics For Simple Hand Lacerations In Emergency Setting?

Abstract

OBJECTIVE: The purpose of this study is to determine the necessity of antibiotics in the management of simple, nonbite wounds of the hand in emergency department.
METHOD: This prospective observational clinical study was done at a tertiary care university hospital emergency department (ED). All patients presented to the ED with a complaint of hand laceration were included into the study. A telephone follow up had been performed for each patient after the seventh day of ED visit. Patients who had tendon, nerve, bone injuries and taking oral antibiotic, and couldn’t be reached by telephone follow up were excluded from the study. Study forms were analyzed for several variables including demographics, mechanism of injuries, degree of contamination and therapeutic procedures. Wound healing, infection rate and antibiotic usage were documented by telephone follow up.
RESULTS: During the study period, 355 patients were presented to the ED with simple hand lacerations. A total of 163 patients of 355 were enrolled into the study, 108 (66.3%) were male and 55 (33.7%) were female. Mean and median ages of patients were 29.3 and 28, respectively. During the follow up period, 3 (1.8%) patients had infections. There was no relationship between the mechanism of injury, degree of contamination and development of infection.
CONCLUSION: Prophylactic antibiotic usage for the management of nonbite simple hand laceration is not necessary in the emergency setting.