Our Summary

This study focused on hand infections in people with diabetes, a problem that can cause serious issues like disability, contractures (permanent tightening of muscles, tendons, skin, or scar tissue that causes loss of motion), amputation, and even death. The researchers examined 49 cases of diabetic hand infections, split into two categories - superficial (on the surface) and deep infections.

The average age of the patients was just over 51 years old. They found 21 superficial infections and 28 deep infections. The cause of the infection was often unknown, but could be due to injuries or small wounds that were not properly cared for. Most of the patients were dependent on insulin, and five were diagnosed with diabetes while being treated for their hand infection.

Most of the patients (92%) required surgery to treat the infection, like draining the wound and removing infected tissue. In some cases, the wound was left open and healed over time with regular dressing changes. In 16 cases, part of the finger had to be amputated. The researchers took samples of the infections to test what bacteria were causing them, which helped them decide which antibiotics to use.

Two patients died from severe infections that spread throughout their bodies, and both of them were insulin-dependent and had kidney failure. One patient developed a severe mental disorder. The researchers concluded that for people with diabetes, it’s crucial to quickly diagnose and treat hand infections with the right antibiotics and surgery if needed. Sometimes, amputating the infected part can save the patient’s life and the rest of the limb.

FAQs

  1. What was the focus of this study on hand surgery?
  2. What are some potential serious issues that can arise from hand infections in people with diabetes?
  3. What are the usual methods of treating hand infections in diabetic patients according to this study?

Doctor’s Tip

A doctor might tell a patient undergoing hand surgery to follow post-operative care instructions carefully, including keeping the incision site clean and dry, taking prescribed antibiotics as directed, and attending follow-up appointments. It’s important to report any signs of infection, such as increased pain, redness, swelling, or drainage, to the doctor immediately. Additionally, engaging in hand therapy exercises as recommended can help promote healing and restore function in the hand.

Suitable For

Patients who are typically recommended hand surgery include those with:

  1. Hand infections, especially in individuals with diabetes
  2. Hand injuries or trauma
  3. Nerve compression syndromes (e.g. carpal tunnel syndrome)
  4. Tendon or ligament injuries
  5. Arthritis affecting the hand joints
  6. Dupuytren’s contracture (a condition where the fingers become permanently bent)
  7. Tumors or cysts in the hand
  8. Congenital hand deformities
  9. Chronic pain or stiffness in the hand affecting daily activities
  10. Other conditions affecting the hand that do not respond to non-surgical treatments.

Timeline

Before hand surgery, a patient may experience symptoms such as pain, swelling, redness, warmth, and pus at the site of infection. They may also have difficulty moving their hand or fingers and may experience fever and chills. The patient would typically visit a doctor or hand surgeon for an evaluation, where they may undergo imaging tests like X-rays or MRIs to determine the extent of the infection.

After surgery, the patient will likely have a recovery period where they need to rest and keep the surgical site clean and dry. They may need to take antibiotics prescribed by their doctor to prevent further infection. Physical therapy may be recommended to help regain strength and range of motion in the affected hand. Follow-up appointments with the surgeon will be necessary to monitor healing and ensure there are no complications. With proper care and treatment, the patient can expect to see improvement in their hand function and overall health.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with hand surgery for a diabetic patient?
  2. How will diabetes impact the healing process after hand surgery?
  3. What specific precautions should be taken before and after surgery to prevent infections?
  4. How will diabetes management, such as insulin use, impact the surgical procedure and recovery?
  5. What type of follow-up care and monitoring will be necessary after hand surgery for a diabetic patient?
  6. Are there any lifestyle changes or modifications that should be considered to prevent future hand infections in diabetic patients?
  7. What signs or symptoms should a diabetic patient look out for that may indicate a potential hand infection?
  8. How can diabetic patients best care for their hands to prevent infections and promote overall hand health?
  9. Are there any specific dietary recommendations or nutritional guidelines that can help with wound healing and infection prevention in diabetic patients undergoing hand surgery?
  10. What is the likelihood of recurrence of hand infections in diabetic patients, and what can be done to minimize this risk?

Reference

Authors: Bahar Moni AS, Hoque M, Mollah RA, Ivy RS, Mujib I. Journal: J Hand Surg Asian Pac Vol. 2019 Sep;24(3):317-322. doi: 10.1142/S2424835519500401. PMID: 31438802