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Arch Hand Microsurg. 2019 Mar;24(1):1-9. Korean. Original Article. https://doi.org/10.12790/ahm.2019.24.1.1
Jang IS , Shin HD , Park MH , Cha SM .
College of Nursing, Chungnam National University, Daejeon, Korea.
Department of Infection Control, Chungnam National University Hospital, Daejeon, Korea.
Department of Orthopedic Surgery, Chungnam National University School of Medicine, Daejeon, Korea. smcha@cnu.ac.kr
Abstract

Purpose

We sought to determine the factors associated with the severity of aggravated hand lesion in patients with diabetes mellitus (DM).

Methods

DM patients with hand lesions ranging from non-suppurative/suppurative to gangrenous (which require surgical treatment) were selected for analysis. Between January 2008 and June 2016, 216 patients with signs of of redness, swelling, and pain with lesions between the fingertip and wrist were analyzed retrospectively. Patients were grouped according to whether they received conservative treatment (group 1) or operative treatment (group 2), and univariate and multivariate analyses were performed according to demographic, laboratory data, co-morbidities, and method of diabetic treatment in both groups.

Results

Age, duration of the morbidity, gender, smoking, co-morbidities, body mass index, other laboratory findings, onset time before treatment, and the presence/classification of trauma history, were all not significant. However, Hb1Ac was found to be 5.96%±0.80% and 8.01%±0.82% in group 1 and 2 respectively, which differed significantly (OR=58.5, p < 0.001).

Conclusion

It is possible to manage hand lesions in DM patients with a variety of methods, ranging from conservative to surgical treatment. HbA1c level was determined to be the most important contributing factor in selection of the more rigorous surgical treatment. Moreover, it was determined that even subtle lesions should not be neglected in DM patients as they are susceptible to rapid progression if left untreated.

Copyright © 2019. Korean Association of Medical Journal Editors.