title: Factors determining poor prognostic outcomes following diabetic hand infections.
abstract: OBJECTIVE
  Hand ulcers are seen in a small percentage of patients with diabetes. The predisposing factors of diabetic hand varies between different countries. However, the effects of predisposing factors on prognosis are not clear in diabetic hand infections. In this study, our aim was to determine the effects of predisposing factors on poor prognostic outcomes in patients with diabetes mellitus.
  
  
  METHODS
  Thirty-four patients with diabetes mellitus who were treated and followed up for a hand infection in between 2008 and 2014 were investigated retrospectively. Patients were evaluated according to predisposing factors defined in the literature that included disease period, age, gender, admission time, presence of neuropathy, smoking habits, HbA1c levels at admission time, peripheral vascular disease, end-stage renal disease (ESRD), and trauma. Death and minor/major amputation cases during treatment were defined as poor prognosis.
  
  
  RESULTS
  Patients who had ESRD, peripheral neuropathy, or an HbA1c level greater than 10% had significantly higher amputation rates.
  
  
  CONCLUSIONS
  Peripheral neuropathy, ESRD, and HbA1c levels greater than 10% at the time of admission were determined as poor prognosis criteria for diabetic hand treatment.
authors.affiliation: Bilsev Ince, MD. Department of Plastic & Reconstructive and Aesthetic Surgery, Faculty of Meram Medicine, Necmettin Erbakan University, 42080 Meram, Konya, Turkey.
authors.forename: Bilsev
authors.initials: B
authors.lastname: Ince
authors.affiliation: Mehmet Dadaci, MD. Department of Plastic & Reconstructive and Aesthetic Surgery, Faculty of Meram Medicine, Necmettin Erbakan University, 42080 Meram, Konya, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Dadaci
authors.affiliation: Abdullah Arslan, MD. Department of Underwater and Hyperbaric Medicine, Faculty of Meram Medicine, Necmettin Erbakan University, 42080 Meram, Konya, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Arslan
authors.affiliation: Zeynep Altuntas, MD. Department of Plastic & Reconstructive and Aesthetic Surgery, Faculty of Meram Medicine, Necmettin Erbakan University, 42080 Meram, Konya, Turkey.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Altuntas
authors.affiliation: Mustafa Kursat Evrenos, MD. Department of Plastic & Reconstructive and Aesthetic Surgery, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
authors.forename: Mustafa Kursat
authors.initials: MK
authors.lastname: Evrenos
authors.affiliation: Mehmet Fatih Karsli, MD. Dr. Sami Ulus Maternity-Children's Health and Diseases Training and Research Hospital, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Fatih Karsli
keywords: Amputation; Diabetic hand; Hand infection; HbA1c; Peripheral neuropathy; end-stage renal disease