Hand Infections
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Infections of the hand and fingers are very common and is experienced by everyone at least once or twice in their lifetime.They are most commonly due toinadvertentinjury to the fingers or hand during occupation or doing day-to-day work.
The most common hand infections are infection of the pulp region of the fingertips or around the nails which is called as paronychia.
Hand infections are common in patients with diabetes and other immunocompromised condition or with patients with CKD. Usually starts with a trivial trauma.
Infections of the hand can also happen along the backside of the skin of hands, along the sheath covering the tendons of the fingersor in the spaces between them
Hand infections should be managed very aggressively and judiciously.If they are left untreated,can lead to spread of infection to the forearm or arm region mandating much more bigger surgery or the patient can land up in septicemia which is the infection spreading in the whole of the body.
Untreated,inadequately treated or badly treated hand infections canalso lead to severe hand deformities
Symptoms of Hand Infection
Hand infections usually start with
- Redness and Swellingof the involved area
- Severe throbbing pain on keeping the hand down
- Restriction in movements of the hand
- Fever may be present
- Look for pus formation in the area (sign of fluctuation)
This redness and swelling can progresses proximallyand upwards, lead to necrosis of the underlying muscles and tendons, spread of infection to the bone, if left untreated.
Management of Hand Infections
- Proper clinical examination is done to look for the extent of the infection and the possible source
- Any coexisting diseases are probed and their status is enquired
- Pus is sent for culture sensitivity
- All pre-operative investigations are sent
- X rays are done to rule out possible fractures
Conservative management
Conservative management is successful only in cases where there is mild redness or pain without any fluctuation (sign of pus formation
- Managed with empirical therapy of IV antibiotics
- Regular dressingsare done
- Limb elevation
- Optimization of diabetes mellitus and control of CKD is done
Surgical management
Incision and drainage of the area where pus is pointing- is done and pus is sent for culture and sensitivity. This is the standard treatment for most of the cases of fingertip infections or infections around the nail bed. The procedure is usually done under local anaesthesia.
For infections of the other regions of thehand, incision and drainage is done with longer incisions depending on the area involved.This procedure requiresgeneral anaesthesia or brachial block.
Urgent Fasciotomy is done if tight compartment or impending tight compartment is present of the forearm or hand.
In neglected cases of hand infection all the necrotic musclesand tissues are removed and appropriate reconstruction to be planned at a later date.
Post operative management
- Daily dressing of raw area is done or can be done with VaccumAssisted Closure (VAC) for about 7 days
- Wound is than assessed and closure is done as per protocol of the reconstruction of soft tissue defects of hand.Kindly visit the soft tissue defects of hand pagefor information of the reconstruction.
- It is usually achievedwith secondary Skin suturing/ skin graft/local flap covers. In rare case where there is a big defect over hand, microsurgical reconstruction can be done
- Immobilization with hand elevation
- Regular physiotherapyand exercises
Hand Infections
Indivisual results may vary from person to person.
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Best plastic surgeon, Dr. Amit Agarwal is an American Board Certified, extensively trained, and best Plastic & Aesthetic surgeon in Lucknow. He is the Chief Plastic Surgeon heading the Department of Plastic, Microvascular, and Craniofacial surgery at Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, U.P, India. He maintains a busy practice at Avadh and Nishat Hospital and his own center - Kayakriti Plastic Surgery & Dental Center. He was formerly a Consultant in the Department of Plastic Surgery and Burns at the prestigious SGPGI, Lucknow.
MS, DNB (General Surgery) MCh, DNB (Plastic Surgery),
MNAMS, FACS, FICS, FRCS (Edinburgh, UK)
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If you have flat or small breast and you want to improve your breast and hip contour ratio then you are a good candidate for it. The answer will be best provided after the first consultation with Dr Amit Agarwal.
Acute pain will be there for almost a week which gradually reduces and there will be soreness and swelling which may take up to 3 weeks to subside.
You can join your work and daily routines after a week of the procedure and can start exercising after 3 weeks of it.
Yes, you have to wear it round the clock unless we suggest you to remove it.
This surgery does not affect the ducts or the areas of the breast involved in milk production. Thus, it does not affect the breast feeding.
This surgery does not affect the ducts or the areas of the breast involved in milk production. Thus, it does not affect the breast feeding.
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D-43, Near Punjab National Bank, Rajajipuram, Lucknow, Uttar Pradesh - 226017, India
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