Hand Infections

Abstract

Hand infections can lead to devastating impact on functional outcomes and should be treated promptly and properly. Detailed history and examination, and occasionally radiological imaging, are necessary to guide a physician to the correct diagnosis. Antimicrobial treatment and/or surgical drainage are mainstays of treatment of hand infections.

Skin Popping for the Hand Surgeon

“…Initial management with thorough history, physical examination, and computed tomography imaging in cases concerning for deep space infection or NSTI is recommended per typical management protocols for upper extremity infections. 8,48 In addition, patients with a history of IVDU are at high risk for hepatitis B, hepatitis C, and alcoholic liver disease, which may necessitate liver function tests and coagulation studies to assess risk for excessive intraoperative bleeding. 29 Skin popping has specific associated medical conditions that must be considered if suspected.…”

“…Hand surgeons are often faced with challenging clinical scenarios when treating these patients in the acute setting for infections or chronic setting for reconstruction. Because of the tissue necrosis, tendon dysfunction, and pressure in the enclosed spaces of the hand, 8,9 SSTIs of the hand must be treated with urgency. Complex SSTIs of the upper extremity often present to hand surgeons late in their clinical course and can cause a significant burden to the patient, 8,10 surgeon, and the health care system.…”

“…Because of the tissue necrosis, tendon dysfunction, and pressure in the enclosed spaces of the hand, 8,9 SSTIs of the hand must be treated with urgency. Complex SSTIs of the upper extremity often present to hand surgeons late in their clinical course and can cause a significant burden to the patient, 8,10 surgeon, and the health care system.…”

Akute Infektionen der Hand – Ein Überblick über das Keimspektrum und gängige Antibiotika

“…Demgegenüber zeigen sich bei Katzenbissen eher oberflächlich kleine, jedoch penetrierende Bissspuren, welche die Pathogene in die Tiefe einbringen, die Wunden sich rasch verschließen und die Keime so in der Tiefe gehalten werden. In der Folge werden diese Wunden häufig unterschätzt [17,18]. Nach derartigen Verletzungen sollte neben der klassisch-chirurgischen Wundtherapie unbedingt der Immunstatus des Tieres, vor allem hinsichtlich einer möglichen Tollwuterkrankung evaluiert werden -im Zweifel sollte eine Immunisierung des Gebissenen erfolgen.…”

“…Weitere wichtige Keime im Zusammenhang mit Bissverletzungen sind S. aureus und Viridans-Streptokokken. In den allermeisten Fällen handelt es sich bei Bissverletzungen um Mischinfektionen, welche die orale Flora des entsprechenden Tieres repräsentiert [2,15,17].…”