Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun 14;13(1):157.
doi: 10.1186/s13643-024-02573-6.

Protocol for a systematic review and network meta-analysis of the use of prophylactic antibiotics in hand trauma surgery

Chen Zhang  1 , Suraya Mohamed Yusuf  2 , Soma Farag  2 , Ryckie George Wade  3 , Justin Conrad Rosen Wormald  4
Affiliations

Protocol for a systematic review and network meta-analysis of the use of prophylactic antibiotics in hand trauma surgery

Chen Zhang et al. Syst Rev. .

Abstract

Background: The use of prophylactic antibiotics in surgery is contentious. With the rise in antimicrobial resistance, evidence-based antibiotic use should be followed. This systematic review and network meta-analysis will assess the effectiveness of different antibiotics on the prevention of surgical site infection (SSI) following hand trauma surgery.

Methods and analysis: The databases Embase, MEDLINE, CINAHL and CENTRAL, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform will be searched. Abstracts will be screened by two persons independently to identify eligible studies. This systematic review will include both randomised and non-randomised prospective comparative studies in participants with hand and/or wrist injuries requiring surgery; bite injuries will be excluded. The network meta-analysis will compare the use of different prophylactic antibiotics against each other, placebo and/or no antibiotics on the development of SSI within 30 days of surgery (or 90 days if there is an implanted device). The Cochrane risk-of-bias tool 2 will be used to assess the risk of methodological bias in randomised controlled trials, and the Newcastle-Ottowa scale (NOS) will be used to assess the risk of bias in non-randomised studies. A random-effects network meta-analysis will be conducted along with subgroup analyses looking at antibiotic timing, injury type, and operation location. Sensitivity analyses including only low risk-of-bias studies will be conducted, and the confidence in the results will be assessed using Confidence in Network Meta-Analysis (CINEMA).

Discussion: This systematic review and network meta-analysis aims to provide an up-to-date synthesis of the studies assessing the use of antibiotics following hand and wrist trauma to enable evidence-based peri-operative prescribing.

Systematic review registration: PROSPERO CRD42023429618.

Keywords: Antibiotic; Hand; Network meta-analysis; Surgical site infection; Wrist.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Similar articles

See all similar articles

References

    1. Statistics » A&E attendances and emergency admissions. Available from: https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-.... Cited 2023 Aug 16
    1. Manley OWG, Wormald JCR, Furniss D. The changing shape of hand trauma: an analysis of Hospital Episode Statistics in England. J Hand Surg Eur. 2019;44(5):532–536. doi: 10.1177/1753193419828986. - DOI - PubMed
    1. O’Sullivan ME, Colville J. The economic impact of hand injuries. J Hand Surg Edinb Scotl. 1993;18(3):395–398. doi: 10.1016/0266-7681(93)90072-N. - DOI - PubMed
    1. Rosberg HE, Carlsson KS, Cederlund RI, Ramel E, Dahlin LB. Costs and outcome for serious hand and arm injuries during the first year after trauma – a prospective study. BMC Public Health. 2013;13(1):501. doi: 10.1186/1471-2458-13-501. - DOI - PMC - PubMed
    1. The economic impact of hand injuries. Available from: https://journals.sagepub.com/doi/epdf/10.1016/0266-7681%2893%2990072-N. Cited 2023 Aug 21 - DOI

MeSH terms

Substances