Serious infection following wounds and bites of the hand

The case notes of 56 patients with severe hand infections requiring hospital admission were reviewed. Most followed injury. The outcome, particularly in mammalian bites, was often poor and approximately one third suffered residual disability. Those with poor outcome generally had infection in tendon sheath, joint or bone. Forty-four patients presenting to the emergency department at Christchurch Hospital with mammalian bites were also reviewed. Dog bites were common and most were well treated as outpatients. Human bites, while less common, had a higher incidence of infection requiring admission. Thorough exploration, debridement and drainage of wounds of the hand are necessary in all cases, but particularly in mammalian bites, for which a suggested management protocol is provided.