Trauma-Related Hand Infections at Siriraj Hospital
Raywat Chunhasuwankul MD*
Affiliation : * Division of Trauma Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Hand infections are the common causes of working hours loss and morbidity for workers and housewives.
Most of hand infections are caused by trauma. To identify the causes of infection, types, organisms and to initiate prompt
appropriate medical or surgical treatment can prevent substantial morbidity. There are some literatures about trauma
related hand infections around the world but not from Thailand. The author tried to study the prevalence of trauma related
hand infections in Thai people.
Objective : To study types of hand infections, age, sex, occupation, mechanisms of injury, bacterial organisms and residual
complications in trauma patients.
Material and Method: This retrospective study was carried out at Division of Trauma Surgery, Department of Surgery,
Faculty of Medicine Siriraj Hospital from January 2006 to December 2010. The patients, who could not be identified
regarding the cause or history of their injury, were excluded from this study. The results were analyzed by calculating
percentages and compared by Chi-square.
Results : There were 209 patients in the study. 121 patients (57.9%) were female and 88 patients (42.1%) were male.
Difference types of hand infections included Cellulitis (35.9%), Paronychiae (34.4%), Abscess (23.9%), Felon (3.3%),
bacterial tenosynovitis (1.0%), web space infection (0.5%), thenar space infection (0.5%) and mid palmar space infection
(0.5%). Incidence of hand infections in adolescents, young, middle aged and elderly patients were 7.18%, 30.62%, 37.8% and
24.4%, respectively. The most common cause of hand infection was puncture (43.2%). Staphylococcus aureus was detected
as a single offending organism in 72 out of 115 patients (62.59%). 114 out of 209 cases were manual workers (54.5%).
Stiffness was the most common cause of complications (3.82%) and there was no statistical difference in complications
between male and female.
Conclusion : Trauma was the most common cause of hand infection. Young and middle aged manual workers and houswives
were significantly prone to hand infection. Most common injury was puncture or minute laceration. Staphylococcus aureus
was the most common single offending organism. Stiffness was the leading complication which could be avoided by prompt
appropriate medical and surgical treatment along with vigorous rehabilitation.
Keywords : Hand infection, Trauma, Puncture
