Your SlideShare is downloading. ×
0
A case of diabetic hand wound
Dr Bengusu Oroglu
Istanbul Faculty of Medicine
Underwater and Hyperbaric Medicine
Department
• Hand complications are rare in diabetes.
• In fact, diabetic hand refers to musculoskeletal
manifestons, but not the ulc...
• A 75 year old male applied with a right hand
wound.
• He was diabetic for about 30 years and was on
insulin therapy for ...
Case
• 5 days after the injury , the patient applied to a
local hospital with erythema and edema and pain
of the hand.
• H...
• Wounds were necrotic
and infected with pus.
• Hand was sellulutic.
• Blood sugar levels were
not regulated.
• Infection ...
• Insulin therapy regulated
• Wound debrided
• Culture material sent
• Hyperbaric oxygen
therapy started.
• Streptococcus ...
• Consulted with infectious diseases and proper
antibiotherapy started.
• The wounds were followed by regular debridements...
• At the end of 30 sessions,
HBO therapy was
stopped.
• The patient was followed
for two more weeks.
• The wounds healed t...
Discussion
• The diabetic hand wound is a rare complication
and is not reported much.
• Early debridement and regular woun...
• Jalil A, Barlaan PI, Fung BKK, Ip WJ, hand
infction in diabetic patients, Hand Surgery, 16:
307-312, 2011
• Wang C, Lv L...
Upcoming SlideShare
Loading in...5
×

EWMA 2013 - Ep575 - A case of diabetic hand wound

264

Published on

Dr Bengusu Oroglu
Istanbul Faculty of Medicine
Underwater and Hyperbaric Medicine Department

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
264
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
6
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Transcript of "EWMA 2013 - Ep575 - A case of diabetic hand wound"

  1. 1. A case of diabetic hand wound Dr Bengusu Oroglu Istanbul Faculty of Medicine Underwater and Hyperbaric Medicine Department
  2. 2. • Hand complications are rare in diabetes. • In fact, diabetic hand refers to musculoskeletal manifestons, but not the ulcers for many authors. • Hand ulcers are generally reported from African countries and are known as ‘tropical hand syndrome’. • Therefore, we wanted share our expriences of a diabetic hand ulcer. Introduction
  3. 3. • A 75 year old male applied with a right hand wound. • He was diabetic for about 30 years and was on insulin therapy for the last fifteen years. • 20 days before the application he was wounded by his own partial denture. Case
  4. 4. Case • 5 days after the injury , the patient applied to a local hospital with erythema and edema and pain of the hand. • He was admitted to hospital and antibiotherapy was started. • At the end of two weeks the wound did not improve, so hand amputaion was offered. • When he applied to our center, fever and pain were present besides the wound.
  5. 5. • Wounds were necrotic and infected with pus. • Hand was sellulutic. • Blood sugar levels were not regulated. • Infection markers were high in spite of normal leukocyte count. Case At the time of application At the time of application
  6. 6. • Insulin therapy regulated • Wound debrided • Culture material sent • Hyperbaric oxygen therapy started. • Streptococcus species were isolated in culture. Case 10th day of treatment 5th day of treatment
  7. 7. • Consulted with infectious diseases and proper antibiotherapy started. • The wounds were followed by regular debridements and dressing changes. • Hydrofiber dressings with ionic Ag were preffered for wound care. Case 26th day of treatment19th day of treatment
  8. 8. • At the end of 30 sessions, HBO therapy was stopped. • The patient was followed for two more weeks. • The wounds healed totally at the eight week. • The patient was referred to physiotherapy for full function of the hand. Case
  9. 9. Discussion • The diabetic hand wound is a rare complication and is not reported much. • Early debridement and regular wound care together with proper medication and blood sugar level regulation is the key to treatment. • Hyperbaric oxygen therapy which is not even mentioned can help to promote healing. • We wanted to share our expriences and point out that HBO can be useful as an adjunctive therapy.
  10. 10. • Jalil A, Barlaan PI, Fung BKK, Ip WJ, hand infction in diabetic patients, Hand Surgery, 16: 307-312, 2011 • Wang C, Lv L, Wen X, Chen D, Cent S, Huang H, Li X, Ran X, A clinical analysis of diabetic patients with hand ulcer in a diabetic foot center, Diabetic Medicine, 27:848-851, 2010 References
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×