Die Handinfektion als Folge einer Bagatellisierung von Minimalverletzungen

Abstract

Frequently, the timely onset of adequate treatment is delayed when a hand infection is the result of minor trauma. The patients as well as the physicians are tempted to underestimate this complication. To prove that certain forms of trauma correlate with the degree of underestimation, we have prospectively studied the cases of 105 patients who required hospitalisation and surgical interventions between 2001 and 2003. We defined a cut-off point at 48 hours following trauma and differentiated between patients who appeared within this period from those who came later. Lesions at the fingertips, superficial and punctual injuries were more frequent among patients belonging to the group with the longer delay of treatment onset. Also pain was more intense and swelling of axillary lymph nodes was seen in this group more often. Patients who had been treated elsewhere before, were commonly found in this group as well. Patients who came within 48 hours following trauma required less surgical procedures. Also hospitalisation was shorter. Using a discriminant analysis, we calculated a linear equation to calculate a score, which helps to assess the individual degree of underestimation. This scoring system can help to identify patients who would benefit from early surgical treatment of the hand.

Auswirkung der verspäteten Vorstellung von Handinfektionen beim Handchirurgen – eine retrospektive Single-Center-Studie von 379 Patienten

“…durch Sepsis lebensbedrohlich werden [5]. Es gibt Hinweise in der Literatur, dass eine verzögerte Vorstellung von Patienten mit HI den Verlauf negativ beeinflusst [6,7].…”

Die Behandlung bakterieller Infektionen an den Interphalangealgelenken der Hand

“…One patient underwent amputation after 4 months due to delayed gangrene. Treatment duration was 15.7 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) weeks. Eight patients reported no complaints, 14 suffered mild symptoms, 5 had moderate, and 3 had severe symptoms in daily life.…”

MRSA-Infektion der Hand immuninkompetenter Patienten

“…Infektionen der Hand erfordern regelhaft ein fr ü hzeitiges und radikales chirurgisches Vorgehen [3] . Diesem kommt bei immuninkompetenten Patienten eine noch gr ö ß ere Bedeutung zu als bei immunkompetenten.…”