HAND INFECTIONS 2
1.5.3 Superficial palmer space
With the infection of this space,pus lies superficial to the tendons in the palm, and under the palmer fascia, a collar and stud abcess may show pus in the palm, infection occurs through abrasions on the palm while working.
Appearance:
The hand is swollen on the palmer aspect, the finger flexed with maximum tenderness in the palm, with a possible visible pus point.
Treatment:
Place a transverse incision in palm, on the point of maximum tenderness. The incision is placed in the skin crease, probe the abcess cavity open all areas.
Pack and dress the wound and keep arm in a sling. Antibiotics and analgesics may be required.
1.5.4 Mid palmer space
The pus is deep to the flexor tendons; the space lies superficial to the interossei and metacarpals.
It is separated from the thenar space by fibrous septa from the middle finger metacarpal to the palmer fascia.
Signs:
The hand is huge and swollen almost like an inflated glove. The middle and ring fingers cannot come close and cannot hold a paper sheet.
Treatment:
Use GA and a tournquet
A transverse incision is required in the skin crease, enter the space by the side of the flexor tendons of the ring finger using blunt dissection after incision of skin, do not injure nerves and tendons. Clean, drain, and dress the wound.
Prescribe antibiotics, analgesics, and sling or suspend hand vertically.
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