HAND INFECTIONS

FREQUENCY, INFECTING ORGANISMS AND RESIDUAL COMPLICATIONS.

Abstract

Hand infections are the prime cause of loss of working hours for manual
workers and housewives. The objective was to study different types of hand infections, infecting organisms and to find
out different residual complications. This prospective study was carried out at C.M.H., Peshawar from March 1, 2000
to March 1, 2003. All patients above 12 years were included in the study. Diabetics, immunosuppressed patients, drug
addicts, and patients on steroid or cytotoxic therapy, were excluded from the study. Other exclusion criteria were crush
injuries, burns, compound fractures and skin lacerations. The diagnosis of hand infection was based on history,
physical and roentgenographic examinations of the hand. All the patients were put on Cloxacillin & Gentacin and their
affected hands were elevated. In cases of suppuration, surgical drainage was done & pus was sent for C/S. Early
physiotherapy was instituted & residual complications were recorded..Relative frequencies of different types of hand
infections in 176 cases included Paronychia (22.16%), Cellulitis (21.02%), Felon (19.32%), Proximal & Middle Volar
Space infection (16.48%), web space infection (14.77%), Thenar Space Abscess (3.41%) and midpalmar abscess
1.70%). Frequencies of hand infections in adolescents, young, middle and elderly patients were 14.77%, 52.84%, 25%
and 7.39% respectively. There was no significant difference in frequencies of hand infection amongst males and
females. The percentages of right hand and left hand involvement were 57.38% and 42.61% respectively. The ratio
between manual workers and other patients of hand infections was 2.5:1. Staphylococcus aureus was detected as a
single offending organism in most of the cultures(62.59%) and stiffness was the leading complication(14.20%). The
frequency of complications was significantly more in elderly patients (53.28%) but there was no significant difference
of complications amongst males and females.