Infections of Deep Hand and Wrist Compartments

Abstract

The human hand is the most exposed part of the body to highest risk for injuries, loss of the skin integrity, and to the inoculation of bacteria, most commonly Staphylococcus aureus, Streptococcus β-haemolytic, and gram-negative. In case of an infection, the mobile anatomical structures and the synovial membranes in close proximity to each other may spread the pus towards deep spaces and compartments. Mild early infections without an abscess formation may respond to antibiotics, but at more advanced stage, erythema, swelling, stiffness, and severe pain may ensue. Abscess formation will cause debilitating pain, fever, systemic symptoms, and even sepsis. Necrotizing infections may threaten not only the limb, but also patient’s life. Therefore, an initially “trivial” hand injury should never be neglected, as it might turn into a deep space infection, which must be treated immediately with drainage, wound debridement, and i.v. antibiotics. Delay in diagnosis and inadequate initial management might rapidly lead to abscess formation, destruction of the gliding surfaces and the normal anatomy, and irreparable functional deterioration.

Tendon Adhesion and Novel Solutions

“…Infection is mostly caused by a significant degree of contamination during the initial tendon injury [2,7,106]. The infection rate and severity depend on where the injury happens and how it is caused [107,108]. And a review paper in 2018 reported the most common bacterial populations causing tendon adhesion formation even some devastating effects like gangrenosis.…”

Polymer-Based Constructs for Flexor Tendon Repair: A Review

“…Infection rates increase when the trauma was caused by for example maritime or agricultural activities. In addition, infections depend on the type of injury with increased infection rates for bite wounds, crush injuries, replantation, and injuries with accompanied fractures [ 116 , 117 , 118 ]. In 2018, a review paper [ 119 ] reported the most found microbial populations causing flexor tendon infections such as i.e., Streptococcus pyogenes , Mycobacterium tuberculosis , Mycobacterium tuberculosis , Staphylococcus , and many more with the latter being the most frequently isolated bacterium.…”

Infektionen an der Hand nach Bissverletzungen

“…Perforierende Verletzungen der Gelenkkapsel können in septischer Arthritis mit schmerzhaft eingeschränkter Beweglichkeit des Gelenkes resultieren. Osteitis und Osteomyelitis sind oft mit chronischen Infektionsverläufen assoziiert [11,18]. Selten kommt es zu systemischen Infektionen mit Sepsis, Meningitis, Endokarditis und Organabszedierungen [2,3].…”

“…a b Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen. Vervielfältigung nur mit Zustimmung des Verlages.sultierende Inflammation erhöht sich der Druck in den anatomischen Kompartimenten und kann zu Ischämie und Nekrosen führen[18]. Infiltrationen des Synovialgewebes der Beugesehnen führen zum typischen Bild der Sehnenscheidenphlegmone mit ubiquitärer Schwellung des Fingers, schmerzhafter Beugestellung und Schmerzen bei passiver Extension[19].…”