What Is a Surgical Site Infection After Carpal Tunnel Release?

Purpose: Considerable variation exists in the literature on published rates of surgical site infection (SSI) after carpal tunnel release, ranging over 20-fold, from 0.28% to 6.4%. The reason for this variability is unknown.

Methods: A retrospective review was conducted on 748 open carpal tunnel releases performed under wide-awake local anesthetic no tourniquet in an in-office procedure room. The following three different definitions of infection were used for analysis: definition A: prescription of an oral antibiotic; Definition B: SSI definition by the Centers for Disease Control and Prevention; Definition C: infection that required reoperation.

Results: Infection rate by definition A was 8.9% (67/748), by definition B was 2.3% (17/748), and by definition C was 0.4% (3/748), resulting in a 22-fold range.

Conclusions: The infection rate after carpal tunnel release is heavily influenced by the definition of SSI. The definition of SSI needs to be considered when making comparisons, either in research or quality assurance/quality improvement applications.

Clinical relevance: When analyzing SSI rates, the exact definition of infection must be ascertained to accurately compare an individual's practice or institutional data to the literature.