Tropical diabetic hand syndrome: case report of successfully salvaged threatened dominant hand

Tropical diabetic hand syndrome—Report of 2 cases

“…[ 5 ] Poorly controlled diabetes mellitus, malnutrition, neuropathy, and patient on insulin treatment are some risk factors for the development of TDHS. [ 6 ] The cause many times is unknown to the patient. However, minor pricks and abrasions and inadvertent cuts have been implicated in the cause.…”

“…Hence, prompt incision and drainage are beneficial for those with abscesses and administration of broad-spectrum antibiotics, which covers for anaerobic organisms. [ 6 7 9 ] Health education is very crucial, and this consists of proper hand care, nutrition, and early presentation in the hospital following any form of trauma to the hand, no matter less severity. Improved glycaemic control, early presentation, and early surgical intervention will prevent limb amputation and death.…”

“…[ 5 ] Available treatment options in the prevention or salvaging threatened limbs include adequate glycaemic control, broad spectrum antibiotics with anaerobic cover, early wound debridement, amputation, skin grafting as seen in one of our cases presented, physiotherapy, and possible complex plastic reconstructive procedures. [ 6 ] We are reporting two cases to illustrate the increasing incidences of TDHS and aggressive treatment, where we were able to salvage the second patient [ Figures 1 and 2 ] by early surgical intervention via incision and drainage, whereas the first patient who had a fulminant sepsis of the hand with a threatened entire limb gangrene was relatively salvaged, resulting in a ray amputation of index finger with subsequent split skin grafting [ Figures 3 – 5 ].…”