Eighty-seven patients participated in a prospective, double-blind, clinical study to determine the efficacy of preventive
antibiotics in the management of common open traumatic hand
wounds ranging in severity from single nail bed
injuries with
open fractures to moderately contaminated
wounds involving tendon, bone, joint, and neurovascular structures. Under current medical practice, these
wounds would be treated with
antibiotics. Thirty-nine patients received intravenous
cefamandole and oral
cephalexin and 48 received intravenously and orally administered placebo. With an overall
infection rate of 1.1%, there were no
infections in the
antibiotics group and only one (2.1%)
infection in the placebo group. Aerobic cultures from 97 similar
wounds were 53.6% positive predebridement and 50.5% positive postdebridement. There was no significant difference in rates of
infection or imperfect wound healing between the two groups. The preventive
antibiotics administered were not necessary in treating these
wounds when accompanied by
debridement, irrigation, and rapid primary repair in an operating room environment.