Hand infection in patients with diabetes: a series of 17 cases and a pooled analysis of the literature

Abstract

Background/aim: The aim of this study was to report the clinical characteristics and the treatment outcomes of hand infections indiabetic patients and to review the literature.Materials and methods: The medical records of 17 patients with diabetic hand infections admitted to the Diabetic Foot Care Center oftwo different clinics from January 2012 to October 2017 were reviewed. To perform the pooled analysis, published series (32 studies)were searched in two international databases (www.scopus.com and www.pubmed.com).Results: Of the 17 patients (mean age 61.7 ± 8.5 years), 8 (47.1%) were female. All cases were type 2 diabetes mellitus. The mean durationof diabetes was 9.0 ± 5.96 years and the mean HbA1c was 7.86 ± 1.88%. There was necrosis in 8 patients (47.1%). The most commoncauses were injury during saw and hammer use in 5 patients (29.4%) and injury due to inappropriate nail cutting in 3 patients (17.6 %).Nine (52.9%) patients were operated on. No patients underwent any major amputations or died. In 32 publications, 704 patients withdiabetic hand infections were found. The average age was 53.43 years (n = 591) and 84.29% of patients (322/382) were found to havetype 2 DM. The mean duration of diabetes was 4.12 years (n = 317) and the mean HbA1c was 10.58% (n = 140). The rate of surgicaloperation was 74.59% (323/433).Conclusion: Diabetic hand injuries often occur when using hand tools such as hammers, saws, and knives, and when cutting nails. Itis necessary to use conservative treatment rather than amputation. These patients should consult experienced health care professionals.