PPAK

Background

Reducing surgical site infection (SSI) risk needs to be balanced with proper antibiotic stewardship. No high-quality prospective studies investigating the use of peri-operative antibiotic prophylaxis for K-Wire fixation in the upper limb exist to aid clinicians in decision making. 

The National Institute for Health and Care Excellence (NICE) guidelines state antibiotic prophylaxis should be given for ‘clean surgery involving placement of a prosthesis or implant’ but also states ‘do not use antibiotic prophylaxis routinely for clean non-prosthetic uncomplicated surgery’. Scottish Intercollegiate Guidelines Network (SIGN) guidance states ‘antibiotic prophylaxis is not recommended’ for Orthopaedic surgery without an implant. It is unclear how these guidelines should be interpreted by clinicians for surgery involving K-Wires. 

To evaluate the use of prophylactic peri-operative antibiotics in K-Wire fixation surgery and the subsequent incidence of SSI in the UK a prospective audit is required.

Exclusion criteria: 

– Open fracture 

– Polytrauma 

– Pathological fracture 

– Active infection at the time of surgery 

– Open reduction of fracture required 

Prospective data collection utilising Research Electronic Data Capture (REDCap) web application. 

Outcome: 

Incidence of SSI. 

SSI diagnosis made using the Modified Oppenheim classification. 

Manuscripts will be submitted for publication in a pre-selected indexed, peer-reviewed journal with all eligible trainee collaborators listed as authors.

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