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Factors related to the resolution of treated hand infections
Abstract:
One hundred thirty-eight patients with acute hand infection (81% deep) treated from 1970 to 1980 in hospital were reviewed. Resolution time of infection was slow, 8 days or longer in 57% of 135 patients and 15 days or longer in 28%. Such slow resolution occurred in infection of closed anatomical spaces and included 50% of all pulp space and joint infections, 23% of tenosynovitis, and 24% of subcutaneous dorsal had infections. There was a direct correlation between increasing treatment delay and slower resolution of infections in pulp spaces, palmar spaces, joints, and tendon sheaths. If the mean treatment delay was greater than a brief 2 1/2 days, 69% of tenosynovitis showed delayed resolution. Other factors associated with the rate of resolution were adequacy of surgical drainage, efficacy of antibiotics, and associated diabetes mellitus.
Insights
Delayed treatment of acute hand infections, especially deep ones, significantly slows recovery. Prompt medical attention is crucial for better outcomes in pulp spaces, joints, and tendon sheaths.
Area of Science:
- Hand Surgery
- Infectious Diseases
- Orthopedic Surgery
Background:
- Acute hand infections are common and can lead to significant morbidity.
- Deep-seated infections and those involving specific anatomical spaces present unique challenges in treatment and resolution.
Purpose of the Study:
- To analyze factors influencing the resolution time of acute hand infections.
- To investigate the correlation between treatment delay and infection resolution.
- To identify specific infection types and anatomical locations associated with slower recovery.
Main Methods:
- Retrospective review of 138 patients treated for acute hand infections between 1970 and 1980.
- Analysis of infection resolution times, treatment delays, and anatomical locations.
- Correlation of clinical factors including surgical drainage, antibiotic efficacy, and comorbidities like diabetes mellitus.
Main Results:
- 57% of patients experienced slow infection resolution (≥8 days), with 28% taking ≥15 days.
- Infections in closed anatomical spaces (pulp, joints, tenosynovitis) showed slower resolution.
- Increased treatment delay directly correlated with slower resolution, particularly in tenosynovitis (69% delayed resolution with >2.5 days delay).
Conclusions:
- Treatment delay is a significant factor in the slow resolution of acute hand infections.
- Infections in closed spaces and tenosynovitis require prompt and adequate management.
- Optimizing surgical drainage, antibiotic therapy, and managing comorbidities are essential for improving infection resolution rates.