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Hand infections in patients with diabetes mellitus

R W Connor1, R C Kimbrough, M J Dabezies

  • 1Department of Orthopedic Surgery, Texas Tech University Health Sciences Center, Lubbock 79430, USA.

Orthopedics
|December 1, 2001
PubMed

Insights

Diabetic hand infections can lead to amputation, especially when abscesses form. Prompt bacterial cultures and targeted antibiotic therapy, such as ampicillin/sulbactam or piperacillin/tazobactam with gentamicin, are crucial for managing these infections.

Area of Science:

  • Infectious Diseases
  • Diabetology
  • Hand Surgery

Background:

  • Diabetic patients are susceptible to severe hand infections.
  • Hand infections in diabetics can lead to significant morbidity, including amputation.

Purpose of the Study:

  • To retrospectively analyze diabetic hand infections.
  • To determine risk factors for amputation.
  • To evaluate the microbiological profile and antibiotic treatment protocols.

Main Methods:

  • Retrospective review of 50 diabetic patients with hand infections.
  • Classification of infections into superficial and abscess groups.
  • Bacteriologic culturing and analysis.
  • Review of antibiotic treatment regimens.

Main Results:

  • The overall amputation rate was 14%.
  • Amputation was exclusively observed in patients with abscesses (17.5% of abscess cases).
  • Polymicrobial infections were common (18/38 cultured infections).
  • Common pathogens included gram-negative bacteria and anaerobes.

Conclusions:

  • Abscess formation is a critical predictor of amputation in diabetic hand infections.
  • Prompt bacteriologic analysis guides effective antibiotic selection.
  • Combination antibiotic therapy (e.g., ampicillin/sulbactam or piperacillin/tazobactam plus gentamicin) is indicated.

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