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The Ischemic/Septic Diabetic Hand: Review of Literature and a Case Report

Received: 1 May 2018    Accepted: 17 May 2018    Published: 12 June 2018
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Abstract

The term “diabetic hand” was born to describe the complications of the diabetes mellitus on the hand resulting in a rigid hand with a poor mobility. The traumatic wounds with soft tissue involvement increase the risk of infection. Staphylococcus aureus methicillin-resistant (MRSA) is the most common bacterium isolated in the hand infections. The case report of a type 2 diabetic patient, dialysed with chronic obstructive peripheral artery disease and Monckeberg sclerosis of the vessels of the hands, ischemic necrosis of the right hand fingers is reported by the authors. In the diabetic patient the hands can be infected in the same way that feet could be infected too. Several amputation interventions have been performed with the intent of saving part of the hand. The diabetic hand syndrome (DHS) is an important pathology that requires strong antibiotics and surgery to avoid severe disability as rigidity, contracture and amputation. Apparently, in the last years good results are reported using antibiotic, surgical and hyperbaric treatment. In conclusion it would be wrong to ignore or underestimate this disease and any doctor should practice a scrupulous visit of the hands in the diabetic patient.

Published in Journal of Surgery (Volume 6, Issue 4)
DOI 10.11648/j.js.20180604.11
Page(s) 82-87
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Ischemia, Gangrena of Meneley, Diabetic Hand, Monckeberg’s Sclerosis, Sepsis

References
[1] Akintewe TA, The diabetic hand – 5 illustrative case reports. Br J Clin Pract 1984; 38: 368-371.
[2] Yacoubi A, Al-Shobaili H. Clinical and microbiological characteristics of hand infection in female patients with diabetes attending University in qassim, Saudi Arabia. Ibnosina J Med B S 2014; 85-90.
[3] Canaves Y, Paròn L, Sìndrome de mano diabética. Rev. Méd. Rosario 2013; 79: 118-125.
[4] Lamm MMY, Choi AKY. Pyogenic hand infection-Importance of Gram-negative Organisms. Hong Kong J Orthop Surg 2004; 8: 28-32.
[5] Proubasta Renart I. La mano diabética. Rev Iberoam Cir Mano 2015; 43: 135-141.
[6] Gill G, Archibald L, Abbas ZA, Diabetic hand infections in the tropics, Diabetes' Voice 2003; 48: 17-19.
[7] Mozzarella R, Dubbioso R, Manganelli F, Perretti A, Saldalamacchia G, Un caso di ulcere alle dita delle mani in una paziente affetta da diabete mellito di tipo 1, G. It. Diabetol. Metab 2014; 34: 82-84.
[8] Schiavon F, Circhetta C, Dani L, La mano diabetica, Reumatismo 2004; 56: 139-142.
[9] Jalil A, Barlaan PI, Fung BK, Ip JW, Hand infection in diabetic patients. Hand Surg 2011; 16 (3):307-312.
[10] Belcher HJCR, Clare TD, Hand Infections, Current Orthopaedics, 2003; 17:28-43.
[11] Connor RW, Kimbrough RC, Dabezies EJ, Hand infections in patients with diabetes, mellitus. Orthopedics 2011; 24 (11): 1057-1060.
[12] Dorko E., Jautovà J, Pilipcinec E, Tkàcikovà L, Occurrence of Candida strains in cases of paronychia. Folia Microbiol (Praha). 2004; 49 (5): 591-595.
[13] Stevenson J, Anderson IVR, Hand infections: An audit of 160 infections treated by an accident and emergency department, J Hand Surg Br 1993; 18 (1): 115-118.
[14] Montes de Oca NJ e al. Sindrome mano del diabético. Reporte de casos, Toluca, Estrado de México, Rev Mex Angiol 2008; 36: 14-20.
[15] Mann RJ, Peacock JM, Hand infections in patients with diabetes mellitus, J Trauma, 1977, 17:376-380.
[16] Francel TJ, Marshall KA, Savage RC, Hand infections in the diabetic and diabetic renal transplant recipient, Ann Plast Surg 1990; 24:304-309.
[17] Gunther SF, Gunther SB, Diabetic hand infections, Hand Clin 1998; 14:647-656.
[18] Mansingh A, Sawh DM, Hand infections in Jamaica, West Indian Med J, 200; 50:309-312.
[19] Kour AK, Looi KP, Phone MH, Pho RWH, Hand infections in patients with diabetes, Clin Orthop 1996; 331:238-244.
Cite This Article
  • APA Style

    Crisci Alessandro, Lombardi Domenico, Lombardi Luisa, Romano Giovanni, Lombardi Guido, et al. (2018). The Ischemic/Septic Diabetic Hand: Review of Literature and a Case Report. Journal of Surgery, 6(4), 82-87. https://doi.org/10.11648/j.js.20180604.11

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    ACS Style

    Crisci Alessandro; Lombardi Domenico; Lombardi Luisa; Romano Giovanni; Lombardi Guido, et al. The Ischemic/Septic Diabetic Hand: Review of Literature and a Case Report. J. Surg. 2018, 6(4), 82-87. doi: 10.11648/j.js.20180604.11

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    AMA Style

    Crisci Alessandro, Lombardi Domenico, Lombardi Luisa, Romano Giovanni, Lombardi Guido, et al. The Ischemic/Septic Diabetic Hand: Review of Literature and a Case Report. J Surg. 2018;6(4):82-87. doi: 10.11648/j.js.20180604.11

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  • @article{10.11648/j.js.20180604.11,
      author = {Crisci Alessandro and Lombardi Domenico and Lombardi Luisa and Romano Giovanni and Lombardi Guido and Crisci Michela},
      title = {The Ischemic/Septic Diabetic Hand: Review of Literature and a Case Report},
      journal = {Journal of Surgery},
      volume = {6},
      number = {4},
      pages = {82-87},
      doi = {10.11648/j.js.20180604.11},
      url = {https://doi.org/10.11648/j.js.20180604.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20180604.11},
      abstract = {The term “diabetic hand” was born to describe the complications of the diabetes mellitus on the hand resulting in a rigid hand with a poor mobility. The traumatic wounds with soft tissue involvement increase the risk of infection. Staphylococcus aureus methicillin-resistant (MRSA) is the most common bacterium isolated in the hand infections. The case report of a type 2 diabetic patient, dialysed with chronic obstructive peripheral artery disease and Monckeberg sclerosis of the vessels of the hands, ischemic necrosis of the right hand fingers is reported by the authors. In the diabetic patient the hands can be infected in the same way that feet could be infected too. Several amputation interventions have been performed with the intent of saving part of the hand. The diabetic hand syndrome (DHS) is an important pathology that requires strong antibiotics and surgery to avoid severe disability as rigidity, contracture and amputation. Apparently, in the last years good results are reported using antibiotic, surgical and hyperbaric treatment. In conclusion it would be wrong to ignore or underestimate this disease and any doctor should practice a scrupulous visit of the hands in the diabetic patient.},
     year = {2018}
    }
    

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    AU  - Crisci Alessandro
    AU  - Lombardi Domenico
    AU  - Lombardi Luisa
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    AU  - Lombardi Guido
    AU  - Crisci Michela
    Y1  - 2018/06/12
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    N1  - https://doi.org/10.11648/j.js.20180604.11
    DO  - 10.11648/j.js.20180604.11
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 82
    EP  - 87
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20180604.11
    AB  - The term “diabetic hand” was born to describe the complications of the diabetes mellitus on the hand resulting in a rigid hand with a poor mobility. The traumatic wounds with soft tissue involvement increase the risk of infection. Staphylococcus aureus methicillin-resistant (MRSA) is the most common bacterium isolated in the hand infections. The case report of a type 2 diabetic patient, dialysed with chronic obstructive peripheral artery disease and Monckeberg sclerosis of the vessels of the hands, ischemic necrosis of the right hand fingers is reported by the authors. In the diabetic patient the hands can be infected in the same way that feet could be infected too. Several amputation interventions have been performed with the intent of saving part of the hand. The diabetic hand syndrome (DHS) is an important pathology that requires strong antibiotics and surgery to avoid severe disability as rigidity, contracture and amputation. Apparently, in the last years good results are reported using antibiotic, surgical and hyperbaric treatment. In conclusion it would be wrong to ignore or underestimate this disease and any doctor should practice a scrupulous visit of the hands in the diabetic patient.
    VL  - 6
    IS  - 4
    ER  - 

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Author Information
  • Unit of Dermosurgery Cutaneous Transplantations and Hard-to-Heal Wound, “Villa Fiorita” Private Hospital, Aversa (CE), Italy; Institute for the Studies and Care of Diabetcs, Casagiove CE, Italy; School of Medicine, University of Salerno Italy, Fisciano SA, Italy

  • School of Medicine, University of Salerno Italy, Fisciano SA, Italy

  • Anesthesia and Resuscitation, Hospital “S. Maria della Pietà”, Nola (Na), Italy

  • Unit of Dermosurgery Cutaneous Transplantations and Hard-to-Heal Wound, “Villa Fiorita” Private Hospital, Aversa (CE), Italy

  • General Surgery, Hospital “S. Maria della Pietà”, Nola (Na), Italy

  • Faculty of Medicine and Surgery, Vasile Goldis Western University of Arad, Arad, Romania

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