Malizos Konstantinos N, Papadopoulou Zoe K, Ziogkou Anna N, Rigopoulos Nikolaos, Athanaselis Efstratios D, Varitimidis Socrates E, Dailiana Zoe C
Hand and Microsurgery Unit, Department of Orthopaedics and Musculoskeletal Trauma Medical School, University of Thessaly, PC41110 Biopolis-Larissa, Greece.
nd Surgical Department, G. Papanikolaou General Hospital, PC57010 Thessaloniki, Greece.
Microorganisms. 2020 Jun 3;8(6):838. doi: 10.3390/microorganisms8060838.
The human hand is the most exposed part of the body to highest risk for injuries, loss of the skin integrity, and to the inoculation of bacteria, most commonly Staphylococcus aureus, Streptococcus β-haemolytic, and gram-negative. In case of an infection, the mobile anatomical structures and the synovial membranes in close proximity to each other may spread the pus towards deep spaces and compartments. Mild early infections without an abscess formation may respond to antibiotics, but at more advanced stage, erythema, swelling, stiffness, and severe pain may ensue. Abscess formation will cause debilitating pain, fever, systemic symptoms, and even sepsis. Necrotizing infections may threaten not only the limb, but also patient's life. Therefore, an initially "trivial" hand injury should never be neglected, as it might turn into a deep space infection, which must be treated immediately with drainage, wound debridement, and i.v. antibiotics. Delay in diagnosis and inadequate initial management might rapidly lead to abscess formation, destruction of the gliding surfaces and the normal anatomy, and irreparable functional deterioration.
人手是身体最易暴露且受伤风险最高的部位，皮肤完整性易受损，且最常感染金黄色葡萄球菌、β溶血性链球菌和革兰氏阴性菌等细菌。发生感染时，彼此紧邻的活动解剖结构和滑膜可能会将脓液扩散至深部间隙和筋膜室。轻度早期感染且未形成脓肿时，使用抗生素可能有效，但在病情进展阶段，可能会出现红斑、肿胀、僵硬和剧痛。脓肿形成会导致剧痛、发热、全身症状，甚至败血症。坏死性感染不仅可能威胁肢体，还可能危及患者生命。因此，最初看似“轻微”的手部损伤绝不可忽视，因为它可能发展为深部间隙感染，必须立即进行引流、伤口清创和静脉注射抗生素治疗。诊断延误和初始处理不当可能迅速导致脓肿形成、滑动面和正常解剖结构遭到破坏，以及功能不可逆转的恶化。
