gms | German Medical Science

Objectives/Interrogation: Pre-operative antibiotics use in percutaneous pinning procedures of the upper extremity is commonly prescribed by many orthopedic surgeons. However, the use of the antibiotics may not be necessary given the low infection rates associated with these procedures. Numerous studies have investigated the need for pre-operative antibiotics in soft-tissue procedures of the upper extremity and found that they did not reduce the overall infection rate. The purpose of this study was to determine the patterns and variation among pediatric orthopedic surgeons in pre-operative antibiotic prescribing practices when performing percutaneous pinning procedures of the upper extremity.

Methods: A survey was sent to all members of the Pediatric Orthopedic Society of North America to assess the current practices and surgeon's thoughts regarding pre-operative antibiotics use for percutaneous pinning procedures of the upper extremity based on location of the procedure. Simple statistics were utilized to analyze the data.

Results and Conclusions: Two hundred ninety-seven surgeons responded to the survey, only 34% reported that their institution had protocols in place to routinely receive pre-operative antibiotics for percutaneous pinning procedures of the upper extremity. Eighty-one percent of surgeons described that they routinely provide antibiotics for all percutaneous pinning procedures of the upper extremity. However, only 60% of surgeons felt that patients undergoing percutaneous pinning procedures of the upper extremity must receive pre-operative antibiotics. When assessing individual joint procedures, 81% of surgeons felt that shoulder procedures required pre-operative antibiotics, 70% of surgeons felt that elbow procedures required pre-operative antibiotics, 66% of surgeons felt that wrist procedures required pre-operative antibiotics, and 62% of surgeons felt that hand/finger procedures required pre-operative antibiotics.

Currently, the majority of institutions do not have protocols for the use of pre-operative antibiotics in percutaneous pinning procedures of the upper extremity. The vast majority of pediatric orthopaedic surgeons (80%) routinely prescribe antibiotics for percutaneous pinning procedures of the upper extremity despite the fact that 40% of surgeons felt that antibiotics were not necessary for all procedures. As the percutaneous pinning procedure is performed more distally on the upper extremity, less surgeons feel pre-operative antibiotics are necessary.