HAND SEPSIS IN PATIENTS WITH DIABETES MELLITUS

Abstract

This is a prospective analytic hospital based study to identify the clinical presentation, risk factors, causative organisms, management and outcome of hand sepsis in diabetic patients. 75 diabetic patients attending Khartoum Teaching Hospital and Gaber Abu Izz Specialized Center were studied during the period between Sep. 2002 to Sep. 2003. The mean age was 49.4 + 12.6 years and the M : F ratio was 1.1 : 1.0. Hand sepsis was founded more common among housewives and employees. Common types of hand sepsis were paronychia in (28.0%), pulp space infection in (28.0%), infection of the other parts of the fingers in (40.0%) and gangrene in (12%) of patients. Peripheral neuropathy in upper extremity occurred in (6.7%) of the patients and most of the patients had good peripheral circulation. 29.3% of patients needed hospital admission, drainage and debridement done in (82.7%) and 17.3% of the patients underwent amputation, 3 patients of them had major upper limb amputation either above or below elbow amputation. 80.0% of the patients had complete healing, 68.0% of them had normal function of the affected part and 12.0% of them had impairment of the function of the affected part. Bacteriological examination showed Staphylococcus aureus in 41.3% of cultures and no growth in 25.3% of cultures. The risk factors for development of hand sepsis in diabetic patients were a history of trauma, poor glycaemic control and housewives job. We recommended that early good blood glucose control, antimicrobial therapy with adequate drainage and debridement to control the sepsis.