The Effect of Intraoperative Corticosteroid Injections on the Risk of Surgical Site Infections for Hand Procedures.

PURPOSE: The aim of the study was to assess the risk of surgical site infection (SSI) in patients who received an intraoperative injection (IOI) with a corticosteroid at the same time as hand surgery for a different condition. METHODS: This was a retrospective chart review of all patients who underwent hand surgery and corticosteroid injections concurrently over an 8-year period. Comparison of the rates of SSI was made of patients who had received an IOI and a matched control cohort of patients with no intraoperative injection (nIOI). There were 391 patients in each group. RESULTS: There were 8 SSIs in the IOI group compared with 2 in the nIOI group. One patient in the IOI group had a deep infection whereas all other infections were superficial. In the IOI group, 206 patients had injections on the side ipsilateral to their surgical procedure. Six of these patients had SSIs, a significant difference compared with the control group. There were 185 patients who had contralateral injections. Two of these patients had SSIs. Compared with the control group, this difference was not significant. CONCLUSIONS: Concomitant injection of steroid into the same side as the surgical site increases the risk of postoperative infection. We do not recommend administering a corticosteroid injection at the time of hand surgery. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.