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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2011 December;62(6):459-69
Infections of the hand
Becker H. A., Jones D. B. Jr., Rizzo M.
Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MI, USA
Because of the intricate anatomy and delicate balance of function in the hand, infections affecting the hand can lead to significant morbidity. The spectrum of disease can range from mild skin and subcutaneous infections such as cellulitis to deeper and more severe infections or necrotizing disease. Hand infections can affect the soft tissues about the nail bed, the flexor tendon sheaths, the muscle and fascia, the deep spaces of the hand, as well as the bones and joints of the hand and fingers. Treatments generally include antibiotics and more severe infections typically also necessitate surgery. In addition, wound care, daily debridements and/or dressing changes are an established adjunct to surgery. Offending organisms are commonly bacterial but fungal, viral, atypical mycobacterial, and resistant organisms must also be considered when selecting antimicrobial treatment. Consultation with infectious disease specialists is typically beneficial. Establishing the diagnosis, recognizing and identifying the offending organism(s), and prompt treatment are necessary to eradicate the infection and preserve hand function.