Upper Extremity Infections in Patients With Diabetes Mellitus

Forty-five consecutive diabetic patients with 46 upper extremity infections who underwent surgical debridement were retrospectively reviewed. The infections involved the skin or subcutaneous tissue in 19 patients and the fascia, tendon, muscle, or bone in 27. Twenty-three infections (50%) required a...

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Bibliographic Details
Published in:	The Journal of hand surgery (American ed.) Vol. 24; no. 4; pp. 682 - 686
Main Authors:	Gonzalez, Mark H., Bochar, Sarah, Novotny, Joseph, Brown, Anthony, Weinzweig, Norman, Prieto, Jorge
Format:	Journal Article
Language:	English
Published:	New york, NY Elsevier Inc 01-07-1999 Elsevier Elsevier Science Ltd
Subjects:	Amputation Arm Associated diseases and complications Bacterial diseases Bacterial diseases of the skin Bacterial Infections - complications Bacterial Infections - surgery Biological and medical sciences Debridement Diabetes Diabetes Complications Diabetes. Impaired glucose tolerance Diabetic Nephropathies - complications Endocrine pancreas. Apud cells (diseases) Endocrinopathies Female Human bacterial diseases Humans infection Infectious diseases Male Medical sciences Middle Aged Prognosis Soft Tissue Infections - complications Soft Tissue Infections - surgery upper extremity amputation infection Diabetes upper extremity Endocrinopathy Human Connective tissue disease Skin disease Microbiology Indication Diabetes mellitus Diseases of the osteoarticular system Retrospective Infection Treatment Surgery Debridment Necrotizing fasciitis Amputation Bacteriosis Complication Upper limb Soft tissue Diagnosis
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Summary:	Forty-five consecutive diabetic patients with 46 upper extremity infections who underwent surgical debridement were retrospectively reviewed. The infections involved the skin or subcutaneous tissue in 19 patients and the fascia, tendon, muscle, or bone in 27. Twenty-three infections (50%) required a single operation and 23 required more than 1. Eighteen infections (39%) required an amputation and there were 3 deaths directly related to an infection. Six of 7 infections in which anaerobic organisms were cultured culminated in amputation. Four patients were diagnosed with necrotizing fasciitis. Twenty-one cultures (46%) were polymicrobial. An increased rate of amputation was associated with deep infections below the subcutaneous tissue, renal failure, and infections with gram-negative, anaerobic, or polymicrobial cultures. An increased rate of repeat surgery and a prolonged hospitalization were associated with deep infection and polymicrobial infections. (J Hand Surg 1999; 24A:682–686. Copyright © 1999 by the American Society for Surgery of the Hand.)
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0363-5023 1531-6564
DOI:	10.1053/jhsu.1999.0682