Evidence-based medicine| Volume 35, ISSUE 1, P122-124, January 2010

Download started.


Perioperative Antibiotics for Carpal Tunnel Surgery

  • Robert M. Szabo
    Corresponding author: Robert M. Szabo, MD, School of Medicine, University of California, Davis, 4860 Y Street, Suite 3800, Sacramento, CA 95817
    Department of Orthopaedic Surgery, University of California, Davis, Sacramento, CA
    Search for articles by this author
      A 47-year-old diabetic secretary presents for treatment of numbness, tingling, and nocturnal paresthesias in her right dominant hand that have been present for 3 years. An evaluation including a positive result in a nerve compression test, a positive result in Phalen's test, and decreased sensibility in the median nerve distribution along with electrodiagnostic studies identified carpal tunnel syndrome. Her diabetes is well controlled with diet, and she has no other medical problems. She agrees to your recommendation for right carpal tunnel release.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Hand Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Keith M.W.
        • Masear V.
        • Amadio P.C.
        • Andary M.
        • Barth R.W.
        • Graham B.
        • et al.
        Treatment of carpal tunnel syndrome.
        J Am Acad Orthop Surg. 2009; 17: 397-405
        • Platt A.J.
        • Page R.E.
        Post-operative infection following hand surgery.
        J Hand Surg. 1995; 20B: 685-690
        • Kleinert J.M.
        • Hoffmann J.
        • Miller Crain G.
        • Larsen C.F.
        • Goldsmith L.J.
        • Firrell J.C.
        Postoperative infection in a double-occupancy operating room.
        J Bone Joint Surg. 1997; 79A: 503-513
        • Hanssen A.D.
        • Amadio P.C.
        • DeSilva S.P.
        • Ilstrup D.M.
        Deep postoperative wound infection after carpal tunnel release.
        J Hand Surg. 1989; 14A: 869-873
        • Henley M.B.
        • Jones R.E.
        • Wyatt R.W.
        • Hofmann A.
        • Cohen R.L.
        Prophylaxis with cefamandole nafate in elective orthopedic surgery.
        Clin Orthop Relat Res. 1986; 209: 249-254
        • Andersen B.R.
        • Kallehave F.L.
        • Andersen H.K.
        Antibiotics versus placebo for prevention of postoperative infection after appendicectomy.
        Cochrane Database Syst Rev. 2005; (CD001439)
        • AlBuhairan B.
        • Hind D.
        • Hutchinson A.
        Antibiotic prophylaxis for wound infections in total joint arthroplasty: a systematic review.
        J Bone Joint Surg. 2008; 90B: 915-919
        • Pavel A.
        • Smith R.L.
        • Ballard A.
        • Larsen I.J.
        Prophylactic antibiotics in clean orthopaedic surgery.
        J Bone Joint Surg. 1974; 56A: 777-782
        • Whittaker J.P.
        • Nancarrow J.D.
        • Sterne G.D.
        The role of antibiotic prophylaxis in clean incised hand injuries: a prospective randomized placebo controlled double blind trial.
        J Hand Surg. 2005; 30B: 162-167
        • Ehrenkranz N.J.
        Surgical wound infection occurrence in clean operations; risk stratification for interhospital comparisons.
        Am J Med. 1981; 70: 909-914
        • Jain A.
        • Witbreuk M.
        • Ball C.
        • Nanchahal J.
        Influence of steroids and methotrexate on wound complications after elective rheumatoid hand and wrist surgery.
        J Hand Surg. 2002; 27A: 449-455
        • Rizvi M.
        • Bille B.
        • Holtom P.
        • Schnall S.B.
        The role of prophylactic antibiotics in elective hand surgery.
        J Hand Surg. 2008; 33A: 413-420
        • Bowater R.J.
        • Stirling S.A.
        • Lilford R.J.
        Is antibiotic prophylaxis in surgery a generally effective intervention?.
        Ann Surg. 2009; 249: 551-556
        • Davey P.
        • Malek M.
        • Thomas P.
        Measuring the cost-effectiveness of antibiotic prophylaxis in surgery.
        Am J Surg. 1992; 164: 39S-43S
        • Kulling D.
        • Sonnenberg A.
        • Fried M.
        • Bauerfeind P.
        Cost analysis of antibiotic prophylaxis for PEG.
        Gastrointest Endosc. 2000; 51: 152-156
        • Fischbach M.A.
        • Walsh C.T.
        Antibiotics for emerging pathogens.
        Science. 2009; 325: 1089-1093
        • Block B.S.
        • Mercer L.J.
        • Ismail M.A.
        • Moawad A.H.
        Clostridium difficile-associated diarrhea follows perioperative prophylaxis with cefoxitin.
        Am J Obstet Gynecol. 1985; 153: 835-838
        • Clarke H.J.
        • Jinnah R.H.
        • Byank R.P.
        • Cox Q.G.
        Clostridium difficile infection in orthopaedic patients.
        J Bone Joint Surg. 1990; 72A: 1056-1059
        • Shapiro S.
        • Siskind V.
        • Slone D.
        • Lewis G.P.
        • Jick H.
        Drug rash with ampicillin and other penicillins.
        Lancet. 1969; 2: 969-972
        • Verma M.K.
        • Shah A.S.
        • Jebson P.J.
        Cephalosporins in hand surgery.
        J Hand Surg. 2009; 34A: 755-758
        • Johnson K.D.
        • Johnston D.W.
        Orthopedic experience with methicillin-resistant Staphylococcus aureus during a hospital epidemic.
        Clin Orthop Relat Res. 1986; 212: 281-288
        • Stratchounski L.S.
        • Taylor E.W.
        • Dellinger E.P.
        • Pechere J.C.
        Antibiotic policies in surgery: a consensus paper.
        Int J Antimicrob Agents. 2005; 26: 312-322