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Prophylactic antibiotics for subungual hematoma

Three Part Question

In [the management of subungual hematoma], are [prophylactic antibiotics] indicated to [improve outcome]?

Clinical Scenario

A 25 year old labourer presents to the emergency department with a subungual hematoma of acute onset. After trephination, the patient requests antibiotics. You wonder if such prophylaxis is indicated.

Search Strategy

Medline using the OVID interface 1996-03/04.
[Exp antibiotics OR antibiotic$.mp OR exp antibiotic prophylaxi OR antibiotic OR prophylactic] AND [exp hematoma OR OR OR] AND [exp nails OR nail$.mp OR ungual$.mp OR subungual$.mp]

Search Outcome

Two papers were found neither of which were relevant.


There are no trials of any kind looking at the use of antibiotics on the incidence of infections or complications post subungual trephination.

Clinical Bottom Line

There is no evidence for antibiotic prophylaxis in the management of uncomplicated subungual hematoma.