Infection of the deep space of the palm
Introduction
Introduction to deep palm infection in the palm A deep stab in the palm of your hand or a spread of suppurative tenosynovitis causes an acute infection of two adjacent potential gaps in the deep palm. Intra-palm interstitial infection is caused by the spread of tenosynovitis of the middle finger and ring finger; the inter-floating infection is caused by the infection of the tendon sheath. It can also be infected by direct stab wounds. Most of the pathogens are Staphylococcus aureus. basic knowledge The proportion of illness: 0.006% Susceptible people: no special people Mode of infection: non-infectious Complications: sepsis shock abscess osteomyelitis
Cause
The cause of deep intergalactic infection in the palm
Intra-palm interstitial infection is caused by the spread of tenosynovitis of the middle finger and ring finger. The infection between the inter-finger gap is caused by the infection of the tendon sheath. It can also be caused by direct stab wound. The pathogenic bacteria are mostly Staphylococcus aureus.
Prevention
Deep palm infection prevention
After the hand is stabbed, don't care about the size of the wound and how much bleeding. It is important to judge whether there is any broken thorn in the wound. If there is, first try to pull it out, apply alcohol to disinfect around the wound, and use it to burn or alcohol. The poisonous scorpion manages to pull out the thorn completely. If the exposed part of the thorn is short and the scorpion cannot be clamped, use the sterilized needle to pick up the wound rind, expand the wound properly, let the thorn be exposed as much as possible, and clamp it gently. Out, confirm that there is no stab, squeeze the wound, squeeze out blood stasis, reduce the chance of re-infection of the wound, and finally disinfect the iodine around the wound once, alcohol 2 times, wrapped with sterile gauze, not assured, can eat Xinnuoming prevention inflammation.
Complication
Complications of deep interstitial infection in the palm Complications septic shock abscess osteomyelitis
If the infection is not treated in time, it will cause serious complications. Staphylococcal sepsis is a common cause of death. Typical cases of sepsis have sustained high fever and sometimes shock, while staphylococcal can spread through the blood and cause internal organs. Abscess (such as lung) and bone infection (osteomyelitis) and endocardium, heart valve infection (endocarditis).
Symptom
Symptoms of deep intergalactic infection in the palm Common symptoms Loss of the palm of the hand or a slight uplift of cellulitis
Intervertebral space infection
The normal depression of the palm of the hand disappears, the bulge, the skin is tense, the whitish, and the tenderness is obvious. The middle finger, ring finger and little finger are in a semi-flexion, and passive fingering can cause severe pain. The back of the hand is edematous. There are systemic symptoms such as high fever, headache, rapid pulse, and increased white blood cell count.
Treatment with large doses of antibiotics. Local early treatment with purulent finger inflammation. If there is no improvement in the short term, the drainage should be cut early. Longitudinal incision between the middle finger and the ring finger, the incision should not exceed the lateral stripes of the palm, so as not to damage the shallow arch of the artery. Use the hemostatic forceps to open the subcutaneous tissue to reach the gap in the palm. A small transverse incision can also be made at the distal edge of the palm of the ring finger to enter the inter-palm gap.
2. Interstitial infection
The big fish and thumb are obviously swollen and tender, but the palm of the hand is still depressed; the thumb abducts slightly, the finger is half flexed, and the activity is limited, especially the thumb can not be against the palm. With systemic symptoms.
Examine
Examination of deep palm infection in the palm
Find the pathogen by smear or culture of the specimen (blood, pus, etc.).
Diagnosis
Diagnostic identification of deep intergalactic infection in the palm
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
(1) Interstitial infection
The normal depression of the palm of the hand disappears, the bulge, the skin is tense, the whitish, the tenderness is obvious, the middle finger, the ring finger and the little finger are in the semi-flexion, the passive extension can cause severe pain, the back of the hand is severely edema, and there are systemic symptoms such as high fever, headache, and rapid pulse. , white blood cell count increased and so on.
(two) inter-animal infection
The big fish and thumb are obviously swollen and tender, but the palm of the hand is still depressed. The thumb is slightly abducted, the finger is half flexed, and the activity is limited. Especially the thumb cannot be on the palm, accompanied by systemic symptoms.
