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Master Thesis

Pertinence de l'antibioprophylaxie post-opératoire dans la prise en charge des traumatismes ouverts de la main opérés en urgence

Abstract : Surgical site infections (SSI) after emergency hand surgery can cause considerable morbidity and, in the most severe forms, even toxic shock syndrome. The administration of postoperative antibioprophylaxis aims to reduce the number of SSIs. However, this empirical practice remains controversial because it has no scientific basis. There are many consensual proposals concerning postoperative antibioprophylaxis in general traumatology, but they do not cover the specific field of Hand Surgery except by analogies whose scientific validity has not been established. Furthermore, unnecessary use of antibiotics can be detrimental both to the patient (numerous and frequent side effects) and to society (emergence of bacterial resistance, costs). The main hypothesis of this study is the following: The absence of postoperative antibioprophylaxis does not modify the rate of SSI in the emergency management of open hand trauma. A prospective, single-center cohort study was conducted including a series of 405 patients operated in emergency for open hand trauma. Patients were reviewed in consultation at 7, 14 and 30 days post-operatively. Any patient requiring revision surgery followed by antibiotic therapy Was considered as SSI. The SSI rate measured in this study was 2.22%. This result does not differ from those found in the literature, and therefore does not support the notion that postoperative antibioprophylaxis in the management of open hand trauma is relevant.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03353047
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Submitted on : Thursday, September 23, 2021 - 4:48:11 PM
Last modification on : Tuesday, October 19, 2021 - 11:34:51 PM

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  • HAL Id : dumas-03353047, version 1

Citation

Jean-Charles Hery. Pertinence de l'antibioprophylaxie post-opératoire dans la prise en charge des traumatismes ouverts de la main opérés en urgence. Médecine humaine et pathologie. 2021. ⟨dumas-03353047⟩

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