Diabetic Hand Infections: Factors at Presentation Influencing Amputation and Number of Surgical Procedures
Background Diabetic hand infections are associated with significant morbidity and disability. Amputations cause permanent disability, and multiple surgical procedures lead to morbidity. Diabetic foot infections have been well-studied but literature on hand infections is limited. We undertook a retro...
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2021-09-01
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| Series: | Indian Journal of Plastic Surgery |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1735421 |
| _version_ | 1819116745471819776 |
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| author | Sanjai Ramkumar Madhu Periasamy Praveen Bhardwaj R Ravindra Bharathi Monusha Mohan S Raja Sabapathy |
| author_facet | Sanjai Ramkumar Madhu Periasamy Praveen Bhardwaj R Ravindra Bharathi Monusha Mohan S Raja Sabapathy |
| author_sort | Sanjai Ramkumar |
| collection | DOAJ |
| description | Background Diabetic hand infections are associated with significant morbidity and disability. Amputations cause permanent disability, and multiple surgical procedures lead to morbidity. Diabetic foot infections have been well-studied but literature on hand infections is limited. We undertook a retrospective study of patients with diabetic hand infections operated at our center to study the factors at presentation with significant association with amputation and number of surgical procedures.
Patients and Methods Demographic data of 51 patients was collected. The six parameters, namely, duration of diabetes, “onset of symptoms to presentation” interval, presence of comorbidities, HbA1c level, random blood sugar (RBS) levels at admission, and culture characteristics were selected for statistical analysis to find a relationship with the two outcome variables: number of procedures done and need for amputation.
Results On bivariate analysis, Gram-negative infection was found to have a significant relationship with the need for multiple of procedures (p = 0.014). The mean difference between the “onset of symptoms to presentation” interval between the amputation/non-amputation groups (2.9 days, p = 0.04) and the multiple procedures/non-multiple procedure groups (4.4 days, p = 0.02) was found to be statistically significant. Presence of comorbidities, long duration of diabetes, HbA1c, and RBS levels at admission did not show any statistically significant association with the two outcome variables studied.
Conclusion In the present study, we found that infection with Gram-negative organisms is significantly related to the need for multiple surgical procedures. A delay in presentation can influence the risk of amputation as well as multiple procedures. Institution of early appropriate care is important to get a good outcome. |
| first_indexed | 2024-12-22T05:21:58Z |
| format | Article |
| id | doaj.art-a6092f6772754376991ad335e9d6ef0f |
| institution | Directory Open Access Journal |
| issn | 0970-0358 1998-376X |
| language | English |
| last_indexed | 2024-12-22T05:21:58Z |
| publishDate | 2021-09-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Indian Journal of Plastic Surgery |
| spelling | doaj.art-a6092f6772754376991ad335e9d6ef0f2022-12-21T18:37:42ZengThieme Medical Publishers, Inc.Indian Journal of Plastic Surgery0970-03581998-376X2021-09-01540328929610.1055/s-0041-1735421Diabetic Hand Infections: Factors at Presentation Influencing Amputation and Number of Surgical ProceduresSanjai Ramkumar0Madhu Periasamy1Praveen Bhardwaj2R Ravindra Bharathi3Monusha Mohan4S Raja Sabapathy5Department of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, IndiaDepartment of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, IndiaDepartment of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, IndiaDepartment of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, IndiaDepartment of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, IndiaDepartment of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, IndiaBackground Diabetic hand infections are associated with significant morbidity and disability. Amputations cause permanent disability, and multiple surgical procedures lead to morbidity. Diabetic foot infections have been well-studied but literature on hand infections is limited. We undertook a retrospective study of patients with diabetic hand infections operated at our center to study the factors at presentation with significant association with amputation and number of surgical procedures. Patients and Methods Demographic data of 51 patients was collected. The six parameters, namely, duration of diabetes, “onset of symptoms to presentation” interval, presence of comorbidities, HbA1c level, random blood sugar (RBS) levels at admission, and culture characteristics were selected for statistical analysis to find a relationship with the two outcome variables: number of procedures done and need for amputation. Results On bivariate analysis, Gram-negative infection was found to have a significant relationship with the need for multiple of procedures (p = 0.014). The mean difference between the “onset of symptoms to presentation” interval between the amputation/non-amputation groups (2.9 days, p = 0.04) and the multiple procedures/non-multiple procedure groups (4.4 days, p = 0.02) was found to be statistically significant. Presence of comorbidities, long duration of diabetes, HbA1c, and RBS levels at admission did not show any statistically significant association with the two outcome variables studied. Conclusion In the present study, we found that infection with Gram-negative organisms is significantly related to the need for multiple surgical procedures. A delay in presentation can influence the risk of amputation as well as multiple procedures. Institution of early appropriate care is important to get a good outcome.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1735421diabeteshand infectionamputationgram-negative infectionwound infection |
| spellingShingle | Sanjai Ramkumar Madhu Periasamy Praveen Bhardwaj R Ravindra Bharathi Monusha Mohan S Raja Sabapathy Diabetic Hand Infections: Factors at Presentation Influencing Amputation and Number of Surgical Procedures Indian Journal of Plastic Surgery diabetes hand infection amputation gram-negative infection wound infection |
| title | Diabetic Hand Infections: Factors at Presentation Influencing Amputation and Number of Surgical Procedures |
| title_full | Diabetic Hand Infections: Factors at Presentation Influencing Amputation and Number of Surgical Procedures |
| title_fullStr | Diabetic Hand Infections: Factors at Presentation Influencing Amputation and Number of Surgical Procedures |
| title_full_unstemmed | Diabetic Hand Infections: Factors at Presentation Influencing Amputation and Number of Surgical Procedures |
| title_short | Diabetic Hand Infections: Factors at Presentation Influencing Amputation and Number of Surgical Procedures |
| title_sort | diabetic hand infections factors at presentation influencing amputation and number of surgical procedures |
| topic | diabetes hand infection amputation gram-negative infection wound infection |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1735421 |
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