Hand sepsis in patients with diabetes mellitus

OBJECTIVE: To report on the clinical presentation and possible risk factors leading to hand sepsis, amputation, management, and outcome in diabetic patients presenting to a multidisciplinary diabetic center in Khartoum, Sudan.

METHODS: This is a retrospective descriptive study of all diabetic patients presenting with hand sepsis between September 2002 and March 2008 to Jabir Abueliz Diabetic Centre (JADC) in Khartoum, Sudan.

RESULTS: A hundred and nineteen diabetic patients with hand sepsis were managed in JADC. The causative agent was unknown in 48.7%, and due to trauma in 42.9%. The most common presentation was cellulitis in 36.1% of patients and deep seated abscess in 29.5%. In 22.7% there was significant sensory neuropathy with loss of perception to 10 gm monofilament nylon. An associated foot ulcer was present in 13.4% of patients. One or more digits amputation was carried out in 17 (14.3%) of patients and hand amputation was unavoidable in 2 (1.7%). Complete healing with good function was achieved in 79%. There was no mortality in this series.

CONCLUSION: Hand sepsis in diabetics is a serious complication, but with early presentation to a specialized diabetic care facility, satisfactory outcome could be achieved.