In 20 years through 1981, the author performed 1841 clean foot and ankle operations without any prophylactic antibiotics. Excluded from this study group are patients with compound fractures or open wounds, prior infection, toenail procedures, and other superficial operations. All postoperative wound infections were recorded in a timely manner and healing was documented. Infections occurred in 41 cases (gross infection rate, 2.2%). Thirty-seven cases healed without further surgery and without sequellae from the infection. Three cases required further surgery. One patient developed narrowing of the ankle joint (permanent damage rate, 0.05%). These four patients represent 0.22% of the study group.
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William A. Miller (1983) studied this question.
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