Perioperative antibiotic use in diabetic patients: A retrospective review of 670 surgeries.

PURPOSE: Carpal tunnel syndrome (CTS) has a high incidence in diabetic patients, with a reported incidence up to 21%. In severe cases of CTS, patients may undergo carpal tunnel release (CTR) surgery, which involves the risk of infection and other complications. To decrease the risk of infection, some physicians provide prophylactic antibiotics. Our study examines the effects of prophylactic antibiotic use, especially in a high-risk, diabetic population.

METHODS

A total of 469 CTR surgeries performed by plastic surgery specialists were reviewed for diabetic status at the time of surgery and perioperative antibiotic use. Postoperative infections occurring at the surgical site were recorded. Associations between perioperative antibiotic use and infection in diabetics and nondiabetics were then analyzed.

RESULTS

No significant decrease in infection rate was seen in those who were given perioperative antibiotic use. This relationship held true for diabetics as well.

CONCLUSIONS

No benefit of antibiotic use during CTR surgery was seen. There was, however, a trend toward a protective effect in patients with uncontrolled diabetes mellitus, suggesting that such patients may benefit from perioperative antibiotic use.

LEVEL OF EVIDENCE: III (Retrospective cohort study), Therapeutic.