Hand sepsis in patients with diabetes mellitus.
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.
Ahmed
Mohamed E
ME
Jabir Abueliz Diabetic Centre, University of Khartoum, Khartoum, Sudan. rasheid@usa.net
Mahmoud
Shadad M
SM
Mahadi
Seifeldin I
SI
Widatalla
Abubakr H
AH
Shawir
Mohamed A
MA
Ahmed
Mohamed E
ME
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
D000900:Anti-Bacterial Agents