Trial registration
infection, hand injury, Infection, trauma
INFECTION, WOUND INFECTION, INFECTION
ISRCTN10771059Antimicrobial sutures might reduce wound infection following hand trauma surgery, but we do not know if we can test them in this population. We conducted a small-scale clinical trial of these sutures in hand trauma to ascertain if we could run definitive trials and how best to do so. We could easily recruit and randomize participants, but follow-up was challenging and will require careful planning in future studies.Hand and wrist injuries, also known as ‘hand trauma’, account for one in five A&E attendances and affect five million people in the UK every year. This has a big impact on people’s lives, as the hand and wrist are important in daily life and for earning a living. Infection after surgery for hand injury causes major problems, including more antibiotics, more operations and readmission to hospital. Specially coated stitches, known as ‘antimicrobial stitches’, could reduce infection risk by killing bacteria in and around the wound. Preventing infection would improve recovery and return to normal life. To find out if antimicrobial stitches can be tested properly in hand trauma surgery, we performed a small-scale study comparing antimicrobial stitches with standard stitches in adults undergoing surgical operations for hand and wrist injuries. The study mainly aimed to assess the possibility of a larger, full-scale trial, but we also measured infection rates, hand function, quality of life and employment changes. The results suggest that a larger trial is possible if we can successfully follow people up after their operation.