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

Abstract

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.

Neuromuscular implants: Interfacing with skeletal muscle for improved clinical translation of prosthetic limbs

“…1 In addition, there are increasing numbers of nontraumatic amputations that result from the rising prevalence of diabetes. 2 Regardless of the cause of amputation, loss of a limb impairs patient mobility and drastically affects daily life. The development of advanced prosthetic limbs offers a promising solution to restore motor control after amputation.…”

“…Worldwide, it is estimated that there are over 55 million individuals who have experienced the loss of a limb due to a traumatic event 1 . In addition, there are increasing numbers of nontraumatic amputations that result from the rising prevalence of diabetes 2 . Regardless of the cause of amputation, loss of a limb impairs patient mobility and drastically affects daily life.…”

Factors Affecting 30-Day Outcomes in Patients Undergoing Nontraumatic Upper Extremity Amputation: A Retrospective Descriptive Longitudinal Study

“…2 In patients with upper limb infections, those suffering from DM were also found to be at a markedly greater risk of undergoing upper extremity amputations (UEAs) compared with nondiabetic patients. 3 Therefore, given the projected rise in the prevalence and burden of DM, the incidence of UEAs may be expected to rise as well. 4,5 Both traumatic and nontraumatic UEAs are less common than LEAs and account for 14% to 50% of all amputations.…”