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Upper extremity wound management: intermediate infections.

L E Weeks1, L R Scheker

  • 1Kleinert Institute for Hand and Micro Surgery, Louisville, KY.

The Journal of the Kentucky Medical Association
|August 1, 1991
PubMed
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Prompt evaluation of hand infections, including history and physical exam, is crucial. Prompt, aggressive management, often surgical, is key for bite injuries and infections like flexor tenosynovitis to prevent severe complications.

Area of Science:

  • Hand surgery
  • Infectious diseases
  • Traumatology

Background:

  • Hand infections require prompt and accurate evaluation.
  • Bite injuries, including human, dog, and cat bites, are common causes of hand infections.
  • Penetrating injuries can lead to serious conditions like flexor tenosynovitis.

Purpose of the Study:

  • To outline essential components for evaluating hand infections.
  • To emphasize the importance of timely and aggressive management strategies.
  • To discuss surgical indications for various hand infections, particularly bite wounds.

Main Methods:

  • Review of clinical presentation and diagnostic considerations for hand infections.
  • Emphasis on history taking (position of hand, comorbidities, handedness, age, occupation).

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  • Guidelines for antibiotic use and timing of surgical intervention.

    • Main Results:

    • History and physical examination are critical for diagnosis.
    • Antibiotics should be withheld until cultures are obtained if surgery is planned.
    • Surgical management is often essential for human, dog, and cat bites, and older flexor tenosynovitis.

    Conclusions:

    • Comprehensive evaluation is fundamental for effective hand infection management.
    • Prompt surgical intervention is frequently necessary for bite-related hand infections.
    • Early presentation may allow nonoperative treatment for flexor tenosynovitis, but older cases require surgical drainage.