title: Hand sepsis in patients with diabetes mellitus.
abstract: OBJECTIVE
  To report on the clinical presentation and possible risk factors leading to hand sepsis, amputation, management, and outcome in diabetic patients presenting to a multidisciplinary diabetic center in Khartoum, Sudan.
  
  
  METHODS
  This is a retrospective descriptive study of all diabetic patients presenting with hand sepsis between September 2002 and March 2008 to Jabir Abueliz Diabetic Centre (JADC) in Khartoum, Sudan.
  
  
  RESULTS
  A hundred and nineteen diabetic patients with hand sepsis were managed in JADC. The causative agent was unknown in 48.7%, and due to trauma in 42.9%. The most common presentation was cellulitis in 36.1% of patients and deep seated abscess in 29.5%. In 22.7% there was significant sensory neuropathy with loss of perception to 10 gm monofilament nylon. An associated foot ulcer was present in 13.4% of patients. One or more digits amputation was carried out in 17 (14.3%) of patients and hand amputation was unavoidable in 2 (1.7%). Complete healing with good function was achieved in 79%. There was no mortality in this series.
  
  
  CONCLUSIONS
  Hand sepsis in diabetics is a serious complication, but with early presentation to a specialized diabetic care facility, satisfactory outcome could be achieved.
authors.affiliation: Jabir Abueliz Diabetic Centre, University of Khartoum, Khartoum, Sudan. rasheid@usa.net
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: Ahmed
authors.forename: Shadad M
authors.initials: SM
authors.lastname: Mahmoud
authors.forename: Seifeldin I
authors.initials: SI
authors.lastname: Mahadi
authors.forename: Abubakr H
authors.initials: AH
authors.lastname: Widatalla
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Shawir
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: Ahmed
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000379:methods; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002481:Cellulitis / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003131:Combined Modality Therapy; D015897:Comorbidity; D016001:Confidence Intervals; D048909:Diabetes Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D005734:Gangrene / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006225:Hand / Q000382:microbiology / Q000473:pathology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D018805:Sepsis / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D012720:Severity of Illness Index; D017678:Sex Distribution; D013397:Sudan / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents