Weeks L E, Scheker L R
Kleinert Institute for Hand and Micro Surgery, Louisville, KY.
J Ky Med Assoc. 1991 Aug;89(8):362-8.
A careful history and physical examination, including information regarding position of the hand at the time of injury, presence of other disease, handedness, age, and occupation, are all essential to evaluate hand infection. If surgery is anticipated, antibiotics should generally be withheld until operative cultures are obtained. Infections secondary to human bite injuries are common and are usually caused by a blow of the fist to the mouth. These injuries can produce crippling sequelae, must be managed promptly and aggressively, and often require surgery. Flexor tenosynovitis, often caused by a penetrating injury, may be treated nonoperatively if the patient presents within 24 to 48 hours of onset. Older injuries always require incision and drainage of the flexor tendon sheath. Most authors agree that surgical management of dog bite wounds to the hand is essential. Cat and arthropod bites may also require surgery.
详细的病史和体格检查，包括受伤时手部的位置信息、是否存在其他疾病、用手习惯、年龄和职业等，对于评估手部感染至关重要。如果预计要进行手术，一般应在获得手术培养结果之前停用抗生素。人咬伤继发的感染很常见，通常是由于握拳撞击口腔所致。这些损伤可导致严重的后遗症，必须迅速且积极地进行处理，并且常常需要手术治疗。屈指肌腱腱鞘炎通常由穿透性损伤引起，如果患者在发病后24至48小时内就诊，可采用非手术治疗。陈旧性损伤总是需要切开引流屈指腱鞘。大多数作者认为，手部狗咬伤的手术处理至关重要。猫咬伤和节肢动物咬伤可能也需要手术治疗。
