Surgical outcomes of diabetic hand infections in Lagos, Nigeria

Mofikoya, Bolaji O

doi:10.4314/mmj.v31i3.6

Cited by 5 publications

(12 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Four needed either skin graft or groin flap. Mokifoya et al 19 in their study on 21 patients reported that two of their patients needed skin graft and two needed flap cover. They did a radial forearm artery flap, and both the cases suffered a partial loss.…”

Section: Discussionmentioning

confidence: 98%

Diabetic Hand Infections: Factors at Presentation Influencing Amputation and Number of Surgical Procedures

Ramkumar

Periasamy

Bhardwaj

et al. 2021

Indian J Plast Surg

View full text Add to dashboard Cite

Background Diabetic hand infections are associated with significant morbidity and disability. Amputations cause permanent disability, and multiple surgical procedures lead to morbidity. Diabetic foot infections have been well-studied but literature on hand infections is limited. We undertook a retrospective study of patients with diabetic hand infections operated at our center to study the factors at presentation with significant association with amputation and number of surgical procedures. Patients and Methods Demographic data of 51 patients was collected. The six parameters, namely, duration of diabetes, “onset of symptoms to presentation” interval, presence of comorbidities, HbA1c level, random blood sugar (RBS) levels at admission, and culture characteristics were selected for statistical analysis to find a relationship with the two outcome variables: number of procedures done and need for amputation. Results On bivariate analysis, Gram-negative infection was found to have a significant relationship with the need for multiple of procedures (p = 0.014). The mean difference between the “onset of symptoms to presentation” interval between the amputation/non-amputation groups (2.9 days, p = 0.04) and the multiple procedures/non-multiple procedure groups (4.4 days, p = 0.02) was found to be statistically significant. Presence of comorbidities, long duration of diabetes, HbA1c, and RBS levels at admission did not show any statistically significant association with the two outcome variables studied. Conclusion In the present study, we found that infection with Gram-negative organisms is significantly related to the need for multiple surgical procedures. A delay in presentation can influence the risk of amputation as well as multiple procedures. Institution of early appropriate care is important to get a good outcome.

show abstract

Section: Discussionmentioning

confidence: 98%

Diabetic Hand Infections: Factors at Presentation Influencing Amputation and Number of Surgical Procedures

Ramkumar

Periasamy

Bhardwaj

et al. 2021

Indian J Plast Surg

View full text Add to dashboard Cite

show abstract

“…TDHS is a rare but debilitating cause of morbidity, hospital admissions, and mortality amongst patients with diabetes, especially for patients in the tropics. 7,8 Compared with diabetic foot infection, TDHS seems to be less prevalent. [7][8][9] Some notable risk factors for TDHS include trauma, poor glycaemic control, and malnutrition.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 Compared with diabetic foot infection, TDHS seems to be less prevalent. [7][8][9] Some notable risk factors for TDHS include trauma, poor glycaemic control, and malnutrition. [7][8][9] Complications can range from sepsis, limb deformity, amputation, and death.…”

Section: Discussionmentioning

confidence: 99%

“…It is pertinent to note that lack of patient education on the subject matter, late presentation for care, delay in initiation of broadspectrum antibiotics (preferably intravenous antibiotics), poor glycaemic control, and inadequate wound care can significantly affect the patient's prognosis. [5][6][7][8] Key Points 1. Tropical diabetic hand syndrome, which manifests in swelling and ulceration of the hand and can lead to deformity, disability, amputation, and death, mainly affects patients with diabetes living in the tropics.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Tropical Diabetic Hand Syndrome: A Case Report and Literature Review

Emanah¹,

Ewelukwa²,

Emehinola³

et al. 2022

EMJ Diabet

View full text Add to dashboard Cite

Tropical diabetic hand syndrome (THDS) is an acute complication that mainly affects patients with diabetes living in the tropics. The cause is usually unknown, but it is often preceded by minor trauma to the hand. Other risk factors for TDHS are poor glycaemic control, poorly treated wounds, malnutrition, and diabetic neuropathy. Early signs include swelling and ulceration of the hand. It can rapidly progress to sepsis and may further worsen, leading to deformity, disability, and amputation. If not treated promptly, death may occur. Unlike diabetic foot ulcer, TDHS often goes unreported. Here is a case of a 39-year-old female and a known patient with diabetes who presented to the outpatient department with swelling and tenderness of the left hand, along with foul-smelling purulent discharge. It began after the patient peeled off a patch of scaly, thickened skin over the distal part of their middle finger. Investigations showed high blood sugar and slightly increased leukocyte count. The patient was started on antihyperglycaemic medications and intravenous antibiotics. Urgent surgical debridement was done, which led to amputation of the middle finger. Thereafter, the patient showed significant improvement and was discharged with follow-up instructions. This case report emphasises the importance of timely intervention in cases of tropical diabetic hand syndrome, and the need for adequate patient education on this issue.

show abstract

“…Inadequate or late treatment can result in severe stiffness, contracture and ultimately loss of hand function. 13 Thus, early diagnosis and urgent aggressive treatment should be given to diabetic patients who present with hand infections to prevent long-term morbidity and death.…”

Section: Introductionmentioning

confidence: 99%

Upper limb infections: A comparison between diabetic and non-diabetic patients

Lim

Ahmad

Devarajooh

et al. 2022

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

Background Upper limb infections are common among patients with diabetes mellitus and their sequelae can be debilitating. They tend to present with severe infections but minimal symptoms probably due to neuropathy and vasculopathy among diabetics. The study aims to compare the demographic characteristics, clinical presentations and outcomes of upper limb infections between diabetic and non-diabetic patients. Methods All patients with upper limb infections who were admitted in a tertiary hospital from June 2017 to December 2020 were included in this study. Demographic data, clinical presentations, investigations and outcomes were obtained retrospectively from electronic medical record. There were 117 patients with diabetes mellitus and 127 with no diabetes mellitus. Comparisons were made between these two groups, and statistical analysis was done with SPSS. Results There were 244 patients included; 117 were diabetic and 127 were non-diabetic. Diabetic patients were more likely to present with emergent scenarios, especially necrotizing fasciitis and infective tenosynovitis ( p < .05) with higher erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) readings ( p < .05). Their microbiological cultures were less likely to be negative ( p < .05). Diabetic patients also had poorer clinical outcomes with higher risk of amputation, re-operation and longer duration of hospital stay ( p < .05). Conclusion Upper limb infections among diabetic patients should be treated aggressively. Early diagnosis and surgical intervention might decrease the morbidity and mortality in this group. Prevention of infections should be emphasized.

show abstract

Surgical outcomes of diabetic hand infections in Lagos, Nigeria

Cited by 5 publications

References 19 publications

Diabetic Hand Infections: Factors at Presentation Influencing Amputation and Number of Surgical Procedures

Diabetic Hand Infections: Factors at Presentation Influencing Amputation and Number of Surgical Procedures

Tropical Diabetic Hand Syndrome: A Case Report and Literature Review

Upper limb infections: A comparison between diabetic and non-diabetic patients

Contact Info

Product

Resources

About