We thank Patel et al
1
for the excellent points raised by them and appreciate the opportunity to respond.
It is indeed interesting that although their work found that a preoperative corticosteroid
injection is associated with a greater risk of a serious surgical site infection after
surgery, the absolute proportion of surgical site infections was several orders of
magnitude lower than that in our study. This difference could be attributed to differences
in coding. All large national databases are subject to imprecisions in coding, including
the database used in our study. As mentioned as a limitation of our study, the International
Classification of Diseases, 9th revision, coding system does not allow accurate determination
of the severity and depth of wound complication, although it might be assumed that
return to the operating room for a wound complication suggests greater severity. Nonetheless,
our study and the work of Patel et al
1
help to inform the practice of the use of corticosteroid injections prior to surgery
for thumb basilar joint arthritis. Ultimately, a prospective study is needed to better
understand the risk of infection in patients undergoing thumb carpometacarpal surgery
after they are administered a corticosteroid injection.To read this article in full you will need to make a payment
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Reference
- Response to “Risk of infection in thumb carpometacarpal surgery after corticosteroid injection.J Hand Surg Am. 2022; 47: e11
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No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
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© 2022 by the American Society for Surgery of the Hand. All rights reserved.
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Access this article on ScienceDirectLinked Article
- Letter Regarding “Risk of Infection in Thumb Carpometacarpal Surgery After Corticosteroid Injection”Journal of Hand SurgeryVol. 47Issue 4
- PreviewWe read with interest the article by Qin et al,1 which described 5,046 patients with base-of-thumb osteoarthritis identified in the Humana database using the PearlDiver platform. We noted several similarities, yet striking differences, related to our two 19-year longitudinal cohorts of individual patient data within the National Health Service, accounting for all secondary care, publicly remunerated activities in England.2,3
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