“The role of antibiotics in revision amputation: A single institution 10 Year experience”

Introduction

Revision amputation remains an important consideration in the management of severely crushed or contaminated finger injuries. The duration and type of antibiotic usage in revision amputations vary greatly among providers. This study sought to elucidate the role of antibiotics in revision amputations performed in the emergency department.

Methods

A retrospective review of all patients who underwent revision amputations by the plastic surgery division in the emergency department was performed.

Results

150 patients with 190 digit amputations met the inclusion criteria. 136 patients (91%) received antibiotics at the time of revision amputation. 61 (41%) received a single dose of IV antibiotics alone, 24 (16%) received a course of outpatient oral (PO) antibiotics, and 51 (34%) patients received a combination of a single dose IV and a course of outpatient PO antibiotics. There was an 12% complication rate and a 4% infection rate. There was no significant difference found in the rates of infection across antibiotic groups.

Conclusion

For performing revision amputation in the Emergency Room setting, the best treatment would be meticulous debridement, irrigation, and closure of the wound. We recommend a single dose of IV antibiotic for prophylaxis, except for cases involving mammalian bite wounds.