A prospective study of acute aerobic hand infection in rural and urban hospital

Abstract

The hand is a specialised tool of the body that has a very high representation in the central nervous system for both sensory and motor function and any disability of it affects the work and general well being of the patient extensively. Impairment of function may therefore have psychological, social and economic consequences. This study was aimed at finding out the aetiological organisms involved in hand infections, the site, the relationship to profession and associated morbidity. Over 70% of aerobic infections were found to be due to Staphvlococcus aureus. 10% were to Beta - Haemolvtic Streptococci. Staphvlococcus aureus was commonly resistant to Tetracycline, Ampicillin and Penicillin at U.T.H. in Lusaka, whereas it was sensitive to the above in the rural hospital in Katete.. Over 60% of the patients could not recall any injury prior to the infection. The average stay in hospital after incision and drainage was one day. But loss of working days averaged fourteen from time of infection to commencement of work. Three cases in Katete showed marked disability four weeks after treatment as they had developed frozen hands. These three cases had extensive infection involving multiple spaces of the hand and they all presented two weeks after the first symptoms. Thus, early presentation to hospital with early incision and drainage and early mobilisation and elevation enhanced recovery. No mortalities were recorded in this series.