AB219. SOH25_AB_161. Hand and wrist trauma: antimicrobials and infection—Audit of clinical practice

Background: Hand traumas are the most common injuries treated in emergency departments, accounting for 20% of attendances. Surgical site infections (SSIs) affect 5% of surgical patients. The World Health Organization (WHO) has established guidelines to prevent SSIs, but their application in hand trauma surgery remains unclear. This study aimed to assess adherence to WHO guidelines for SSI prevention in hand trauma surgery at Mater Misericordiae University Hospital (MMUH).

Methods: Data collection occurred over a 2-month period. All patients requiring surgery for hand trauma were included. Patients with infected wounds were excluded. Data analysis was conducted using R statistical software (version 4.3.3). Descriptive statistics were used to summarise all captured data. Dichotomous, categorical, was reported as counts and percentages.

Results: Between 1/4/2024 and 1/5/2024, 44 patients were treated for hand injuries at MMUH. Type of injury included, skin only (n=18), fracture (n=4), tendon (n=14), joint (n=2), and digital nerve (n=6). Prophylactic antibiotics were given in 41/42 (98%) of patients. The average length of antibiotics was 4.6 days. The average time to operation was 41.7 hours. Antimicrobial sutures were not used in any cases.

Conclusions: The WHO advise against extending surgical antibiotic prophylaxis (SAP) postoperatively to reduce the risk of SSIs. The WHO guidelines represent the most comprehensive resource available however, they do not specifically address hand trauma. In contrast, our centre’s practices significantly diverge from these recommendations. This discrepancy highlights a gap between established guidelines and clinical practice. High-quality studies focused on hand trauma and the use of antimicrobials are needed.

Keywords: Antimicrobials; audit; hand trauma; plastic surgery; trauma