This update reviews material presented at the 2010 annual meetings of the American Society for Surgery of the Hand (ASSH), the American Association for Hand Surgery (AAHS), and the American Academy of Orthopaedic Surgeons (AAOS) as well as articles published in the field of hand surgery (other than those published in this journal) between August 2009 and July 2010. Over the years, as with other maturing organizations, the trend has been for fewer free papers and more symposia and hands-on workshops, including many non-continuing medical education (non-CME) credit, industry-sponsored workshops in facilities adjacent to the accredited scientific meeting. In addition, both hand surgery organizations feature presentations on shoulder and elbow surgery and general microsurgery that are beyond the scope of this review.
Meeting abstracts for the American Society for Surgery of the Hand and American Academy of Orthopaedic Surgeons annual meetings are maintained online at www.assh.org and www.aaos.org, respectively.
Are prophylactic antibiotics useful in clean, elective hand surgery cases? Maybe not. A study presented to the ASSH reviewed the results of over 8000 clean, elective hand surgical cases done in an outpatient surgical center. One-third of the patients had been given preoperative prophylactic antibiotics. Postoperatively, the overall wound infection rate was 0.35%. The rate was not significantly different between the patients who received antibiotics and those who did not. Although antibiotic use was not randomized, the two groups did not differ significantly in terms of age, sex, smoking history, or the presence of comorbid conditions such as diabetes. While smoking, the duration of the procedure, and diabetes all were positively associated with an increased risk of infection, the use of preoperative antibiotics did not reduce these risks. The authors concluded that, in clean, elective outpatient hand surgery cases, prophylactic antibiotics were of limited value. A recent report on postoperative …
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