title: [Infection of the hand: evaluation of a two-stage therapy].
abstract: BACKGROUND
  Infections of the hand are common diseases in hand surgery departments. The correct diagnosis and subsequent treatment is difficult and is often underestimated. In literature different and often conflicting treatments are recommended. The present study retrospectively analysed our two-stage surgical treatment.
  
  
  METHODS
  60 patients (mean age: 51 years, 38 male, 22 female) were studied retrospectively on the basis of the diagnosis hand infection (ICD L03.-). In all patients, a rapid and radical surgical debridement without wound closure was performed. An antibiotic therapy was initiated. We investigated how often wound closure during a second-look operation, following a period of open wound treatment with antiseptic dressing was successful possible. Furthermore, the patients were followed up in our outpatient clinic.
  
  
  RESULTS
  A successful secondary wound closure was possible after on average 38.7 h and in 92% of the patients. 8% of patients required further surgical treatment. These patients presented with either an existing disease or a delayed presentation with initial antibiotic treatment. Antibiotic therapy was performed on an average for 8.7 days. Altogether for 85% of the 58 patients examined in our outpatient clinic the therapy could be terminated after 3 weeks with a full recovery of function of the injured hand and with full force measurements. The inability to work was on average 16 days.
  
  
  CONCLUSIONS
  The two-stage surgical treatment, with radical debridement and open wound dressing in our collective is an adequate treatment for infections of the hand. It is a safe procedure, that allows for combination with an antibiotic therapy by which a rapid restoration of function of the injured hand is possible.
authors.affiliation: Berufsgenossenschaftliche Kliniken Bergmannstrost, Plastische- und -Handchirurgie/Brandverletztenzentrum, Halle (Saale).
authors.forename: P A
authors.initials: PA
authors.lastname: Bergmann
authors.affiliation: Universitätsklinikum Schleswig-Holstein Campus Lübeck, Plastische -Chirurgie, Handchirurgie, Intensiveinheit für Schwerbrandverletzte, Lübeck.
authors.forename: K L
authors.initials: KL
authors.lastname: Mauss
authors.affiliation: Universitätsklinikum Schleswig-Holstein Campus Lübeck, Plastische -Chirurgie, Handchirurgie, Intensiveinheit für Schwerbrandverletzte, Lübeck.
authors.forename: M E
authors.initials: ME
authors.lastname: Liodaki
authors.affiliation: Universitätsklinikum Schleswig-Holstein Campus Lübeck, Plastische -Chirurgie, Handchirurgie, Intensiveinheit für Schwerbrandverletzte, Lübeck.
authors.forename: P
authors.initials: P
authors.lastname: Mailänder
authors.affiliation: Berufsgenossenschaftliche Kliniken Bergmannstrost, Plastische- und -Handchirurgie/Brandverletztenzentrum, Halle (Saale).
authors.forename: F
authors.initials: F
authors.lastname: Siemers
authors.affiliation: Universitätsklinikum Schleswig-Holstein Campus Lübeck, Plastische -Chirurgie, Handchirurgie, Intensiveinheit für Schwerbrandverletzte, Lübeck.
authors.forename: F
authors.initials: F
authors.lastname: Stang
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000601:surgery*; D001458:Bandages; D002444:Cefuroxime / Q000008:administration & dosage; D002939:Ciprofloxacin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003646:Debridement; D005260:Female; D005500:Follow-Up Studies; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D058106:Wound Closure Techniques; D014945:Wound Healing / Q000502:physiology; D014946:Wound Infection / Q000601:surgery*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D002444:Cefuroxime