Antibiotic prophylaxis regimes for simple hand lacerations. A randomized double-blind clinical trial

The present study aimed to compare oral antibiotic prophylaxis, topical antibiotic prophylaxis, and simple wound care in uncomplicated minor hand lacerations. A prospective, single-center, randomized, double-blind clinical trial was conducted on patients who presented to the emergency department (ED) with simple hand lacerations. The patients were allocated in a 1:1:1 ratio, to receive oral 500 mg cephalexin monohydrate, topical pomade including 2% mupirocin, or wound cleaning with antiseptic, and dressing only in a blinded fashion. Patients included in the study were called to return for control visits 1 week after their admission to the ED. The primary outcome measure of the study was the presence of infection. Infection was observed in only 7 patients (2.4%) in the follow-up period. None of the prophylaxis methods was superior with respect to infection development (p = 0.87). Mean patient satisfaction rates in the three treatment groups were similar; no statistical difference was observed (p = 0.41). Infection rates were found to be similar among the infection prophylaxis groups with systemic and topical antibiotics and the standard wound care group with no prophylaxis. The use of topical and systemic antibiotics were not superior to standard wound care.