Deep subfascial space infections

Infections of the deep subfascial spaces of the hand and wrist are relatively uncommon but well recognized. Potential sites for infection include the interdigital web space, dorsal subaponeurotic space, Parona's space, thenar space, midpalmar space, and hypothenar space. Treatment involves surgical drainage in combination with appropriate systemic antibiotics. Several alternative surgical approaches have been described. Selection is based on the extent and precise location of the infection and surgeon preference. Aggressive hand therapy usually is required in the postoperative period to avoid the complication of tendon adhesions, joint contractures, and hand stiffness. With early recognition and expedient surgical treatment, a satisfactory outcome can be expected for those infections that occur in otherwise healthy, nonimmunocompromised patients.