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We carried out a systematic review to determine the incidence of infection for hand surgery done in settings other than the operating theatre. Databases were searched and a PRISMA chart created by three independent reviewers. From 1200 studies identified, 46 full text articles were reviewed and six were included (two Level 3 studies and four Level 4). In three studies there were no infections after surgery in an office, procedure room or emergency department. Two studies with a combined number of 1962 procedures reviewed carpal tunnel decompressions and reported identical infection rates of 0.4%. Although the current evidence is of poor quality, it suggests that some types of hand surgery may be done outside the operating theatre without increasing the risk of infection.IV.

Original publication




Journal article


The Journal of hand surgery, European volume

Publication Date





289 - 294


Oxford University Hospitals NHS Trust, Oxford, UK.


Hand, Humans, Surgical Wound Infection, Ambulatory Surgical Procedures