Hand infections: a retrospective analysis

Abstract

Purpose. Hand infections are common, usually resulting from an untreated injury. In this retrospective study, we report on hand infection cases needing surgical drainage in order to assess patient demographics, causation of infection, clinical course, and clinical management.Methods. Medical records of patients presenting with hand infections, excluding post-surgical infections, treated with incision and debridement over a one-year period were reviewed. Patient demographics; past medical history; infection site(s) and causation; intervals between onset of infection, hospital admission, surgical intervention and days of hospitalization; gram stains and cultures; choice of antibiotics; complications; and outcomes were reviewed.Results. Most infections were caused by laceration and the most common site of infection was the palm or dorsum of the hand. Mean length of hospitalization was 6 days. Methicillin-resistant Staphylococcus aureus, beta-hemolytic Streptococcus and methicillin-susceptible Staphylococcus aureus were the most commonly cultured microorganisms. Cephalosporins, clindamycin, amoxicillin/clavulanate, penicillin, vancomycin, and trimethoprim/sulfamethoxazole were major antibiotic choices. Amputations and contracture were the primary complications.Conclusions. Surgery along with medical management were key to treatment and most soft tissue infections resolved without further complications. With prompt and appropriate care, most hand infection patients can achieve full resolution of their infection.

Hand infection patients presenting to an orthopaedic unit: An audit of incidence and demographics at a rural hospital

“…We report 114 cases of hand infections over a 1‐year period. Previous research has indicated low incidences of hand infections, with some hospitals reporting fewer than 20 infections per year; however, other studies have shown rates similar to ours . It appears hand infection incidence is highly dependent on the population residing in a hospital's catchment area.…”

Infections of the hand: an overview

“…2 Acute infections of the hand are considered to be a significant cause of morbidity and mortality; when left untreated, they can lead to tissue destruction and loss of function or even permanent disability. 3,4…”

“…1 Treatment requires a multifaceted approach combining proper antimicrobial therapy, immobilization, oedema control, and adequate surgical therapy. 1,3 Because of the potential for serious morbidity and complications, a combination of aggressive operative and medical therapy should be applied following an early identification in a timely fashion. 1,5 If any further information about the aetiology of the infection is needed, consultation from an infectious diseases specialist is useful in deciding on the appropriate antimicrobial regimen.…”

“…1,5 If any further information about the aetiology of the infection is needed, consultation from an infectious diseases specialist is useful in deciding on the appropriate antimicrobial regimen. 1,3…”

Characterizing Hand Infections in an Underserved Population: The Role of Diabetic Status in Antibiotic Choice and Infection Location

“…Consistent with data reported by other centers, S. aureus was the most commonly identified pathogen in culture overall. [18][19][20][21][22][23] The etiologic agents of hand infection were comparable between the DM and no-DM groups: rates of identification of all S. aureus, MRSA, gram-negative organisms, and polymicrobial cultures did not differ significantly between DM and no-DM groups. The literature describes the rates of culture of gram-negative organisms from hand infections as ranging from 51.1 to 73% in diabetics and 8 to 11.3% overall.…”