Wednesday, April 6, 2011

INFECTIONS IN SURGICAL PRACTICE


1.5 Hand Infections

1.5.1. Anatomy The hand is a special part of the body and is used for holding and lifting objects. It is also used for fine controlled movements, like writing, painting and playing musical instruments. It is made up of bones, and joints, with muscle, and tendons to achieve these movements. The use of hands provides chance of injury, and break in skin cover leading to infections. There are spaces in the hand and fingers where this infection can spread to, and present to the surgeon for treatment.

1.5.2. Hand Spaces

1.5.2.1 Web spaces these are space filled with fat, three in number. They lie between the index, middle, ring, and little finger, and provide entry to infection. If not recognized early and treated, spread may occur to the mid palmer space.

Appearance Pain, and swelling of the dorsum of the hand are the presenting features. The fingers on either side of affected web space are separated. Maximum tenderness is on the palmer aspect.

Treatment: Incision, curve shaped in the web between the affected fingers. Probe and open all pus pockets, pack and dress, keep arm raised in a sling.

Antibiotic if infection is spreading, analgesics will be also required.

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