Is There a Role for Antibiotics in Diabetic Patients Undergoing Carpal Tunnel and Trigger Finger Release? A Retrospective Analysis of 723 Cases.

Abstract

Background: This study aims to assess the role of perioperative antibiotic prophylaxis in surgical site infection (SSI) rates and other associated postoperative complications among diabetic patients undergoing carpal tunnel release (CTR) and trigger finger release (TFR) surgeries to address the gap in literature regarding the effectiveness of prophylactic antibiotics specifically in the diabetic population undergoing hand surgery.

Methods: An institutional review board-approved retrospective review was performed to evaluate CTR or TFR performed in patients with diabetes between June 1, 2011, and June 1, 2021. Patients were identified using International Classification of Diseases, Tenth Revision codes for diabetes and Current Procedural Terminology codes for the surgeries of interest, with exclusions applied for certain prior conditions. The study focused on postoperative complications, particularly wound healing, examining variables such as demographics, outcomes, and perioperative antibiotic use.

Results: The study found an overall postoperative complication rate of 13.9%, with SSIs being the most common. Despite the high prevalence of antibiotic prophylaxis use (82.1%), no significant reduction in postoperative complications or SSIs was observed. The study also examined the impact of glycemic control, body mass index (BMI), and comorbidities on surgical outcomes and found no linear association. However, diabetic patients with a BMI > 29 may have higher complication rates than those with a BMI ≤ 29.

Conclusions: The routine use of perioperative antibiotic prophylaxis does not significantly influence the rate of SSIs and associated postoperative complications in diabetic patients undergoing CTR and TFR. A more tailored approach to antibiotic use, considering individual patient factors beyond glycemic control, may be more appropriate in diabetic patients.