Hand Infections

Abstract

Hand infections are commonly seen by orthopedic surgeons as well as emergency room and primary care physicians. Identifying the cause of the infection and initiating prompt and appropriate medical or surgical treatment can prevent substantial morbidity. The most common bacteria implicated in hand infections remain Staphylococcus aureus and Streptococcus species. Methicillin-resistant S aureus infections have become prevalent and represent a difficult problem best treated with empiric antibiotic therapy until the organism can be confirmed. Other organisms can be involved in specific situations that will be reviewed. Types of infections include cellulitis, superficial abscesses, deep abscesses, septic arthritis, and osteomyelitis. In recent years, treatment of these infections has become challenging owing to increased virulence of some organisms and drug resistance. Treatment involves a combination of proper antimicrobial therapy, immobilization, edema control, and adequate surgical therapy. Best practice management requires use of appropriate diagnostic tools, understanding by the surgeon of the unique and complex anatomy of the hand, and proper antibiotic selection in consultation with infectious disease specialists.

Septic Tenosynovitis of the Hand

“…This consisted of performing a Bruner 17 incision proximally and distally from the infection site and then excising the tendon sheath. In severe cases (Michon stage III), 16,18,19 the entire tendon sheath and all necrotic tendons were removed. All wounds were irrigated with antiseptic-free saline solution (0.9%), left open, and dressed with paraffin-impregnated gauze.…”

“…18 In 1974, Michon described a staging based on the presence or absence of three intraoperative findings: synovial purulence, subcutaneous purulence, and necrosis of the flexor tendon. 19 This classification has been used to help surgeons in selecting the operative technique and predicting the functional outcome.…”

Rare Infections in Pediatric Patients: Herpetic whitlow

“…Oral veya intravenöz asiklovir sadece ciddi enfeksiyonu olan ve immünsuprese hastalarda önerilmektedir. 6 Bununla birlikte yaygın primer enfeksiyon ve tekrarlayan atakların süresini kısaltmada intravenöz asiklovir kullanımı-nın etkili olduğu kabul edilmiştir. 3 Sekonder bakteriyel enfeksiyon olmadıkça antibakteriyel tedavinin gereksiz olduğu bildirilmektedir.…”

“…3 Sekonder bakteriyel enfeksiyon olmadıkça antibakteriyel tedavinin gereksiz olduğu bildirilmektedir. 6 Hastamızın yaşının küçük olması ve enfeksiyonu da ağır olduğu için hastamıza asiklovir tedavisi verildi. Veziküler lezyonu bulanıklaşması ve sekonder bakteriyel enfeksiyonu dışlayamadığımız için antibakteriyel tedavi verdik.…”

Hand Infections

“…Infection may develop in each of these spaces usually as a result of penetrating trauma or contiguous spread from other areas, or occasionally from haematogenous spread [ 12 ]. They invariably require incision and drainage and are combined with appropriate antibiotic therapy.…”