Handinfektionen: Evaluation eines zweizeitigen Therapieregimes

Abstract

▼Introduction: Infections of the hand are common diseases in hand surgery departments. The correct diagnosis and subsequent treatment is diffi cult and is often underestimated. In literature diff erent and often confl icting treatments are recommended. The present study retrospectively analysed our two-stage surgical treatment. Patients and Methods: 60 patients (mean age: 51 years, 38 male, 22 female) were studied retrospectively on the basis of the diagnosis hand infection (ICD L03.-). In all patients, a rapid and radical surgical debridement without wound closure was performed. An antibiotic therapy was initiated. We investigated how often wound closure during a second-look operation, following a period of open wound treatment with antiseptic dressing was successful possible. Furthermore, the patients were followed up in our outpatient clinic. Results: A successful secondary wound closure was possible after on average 38.7 h and in 92 % of the patients. 8 % of patients required further surgical treatment. These patients presented with either an existing disease or a delayed presentation with initial antibiotic treatment. Antibiotic therapy was performed on an average for 8.7 days. Altogether for 85 % of the 58 patients examined in our outpatient clinic the therapy could be terminated after 3 weeks with a full recovery of function of the injured hand and with full force measurements. The inability to work was on average 16 days. Discussion: The two-stage surgical treatment, with radical debridement and open wound dressing in our collective is an adequate treatment for infections of the hand. It is a safe procedure, that allows for combination with an antibiotic therapy by which a rapid restoration of function of the injured hand is possible.

Management peripherer Verletzungen der Finger

“…Auf die Entwicklung einer Beugesehnenscheidenphlegmone ist bei den Kontrolluntersuchungen zu achten [10,11]. Diese zeigt sich durch Rötung, Schwellung, Druckschmerz entlang der betroffenen Sehnenscheide, Beugestellung der Finger, Schmerzen bei passiver Streckung und rasche Ausbreitung entlang der präformierten Räume (V-Phlegmone, Parona-Raum).…”