Diagnostic and Management of Hand Infection.

Condition(s) studied

Investigational drug(s) / intervention(s)

Failure rates: Describe the management failure rate for hand infections, including panariasis, phlegmons and arthritis.

Study summary

Primary or secondary (post-traumatic infections, notably related to bites, wounds, etc.) infections of the hand are very common situations, even if the epidemiology is poorly understood. For example, hand bite injuries represent 1.2 million referrals to the healthcare system per year in the United States. Their nosological framework extends from simple infections of the skin and soft tissues such as whitlows, to potentially severe deep damage such as arthritis and osteitis, or phlegmons of the tendon sheaths. The diagnostic approach is not consensual, and the contribution of additional biological parameters (inflammatory syndrome) and morphological investigations (x-rays, ultrasound, CT-scan or MRI) is not codified. Microbiology seems dominated by Staphylococcus aureus, but few studies have precisely described the microbial etiology. Consequently, probabilistic antibiotic therapy and the need to take bacteriological samples for secondary adaptation are not standardized. Likewise, surgical strategies (abstention, systematic washing or depending on evolution) remain operator dependent. We consequently aim to described diagnostic, management and related outcomes or hand infections in a specialized tertiary care center.

Eligibility

Primary outcome measure(s)

• Percentage of treatment failure during the management of hand infections. — between 01/01/2014 and 31/12/2023.
  Treatment failure will be defined as infection persistence or relapse, need of unplanned surgery for septic reason or infection-related death.

Trial sites (1)

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