title: Hand infections in the diabetic and the diabetic renal transplant recipient.
abstract: We present a series of 41 diabetic patients with severe tissue destruction and deformity secondary to hand infections. Thirty (73%) of the patients showed propagation of the infection to bone, tendons, or deep palmar spaces, and 26 of 41 (63%) required amputations. Sixty-three percent of the cultures were mixed; pure Staphylococcus aureus accounted for only 12%. Diabetics who were renal transplant recipients were at increased risk, with a 100% amputation rate and an average hospitalization of 41 days. Recommendations for management of diabetic hand infections are given to reduce the mortality and morbidity in these patients.
authors.affiliation: Department of Surgery, Johns Hopkins Medical School, Baltimore, MD.
authors.forename: T J
authors.initials: TJ
authors.lastname: Francel
authors.forename: K A
authors.initials: KA
authors.lastname: Marshall
authors.forename: R C
authors.initials: RC
authors.lastname: Savage
mesh_terms: D000328:Adult; D000671:Amputation, Surgical; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D001424:Bacterial Infections / Q000150:complications* / Q000628:therapy; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000150:complications; D005260:Female; D005383:Finger Injuries / Q000150:complications; D005734:Gangrene / Q000209:etiology; D006225:Hand; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000209:etiology; D011183:Postoperative Complications; D013717:Tenosynovitis / Q000209:etiology