Incision and drainage for infections with abscess leave packing in place for 24 to 48 hours, then daily dressing changes to allow for healing by secondary intent Oral antibiotics for seven to 10 days (typically not indicated limit use to immunocompromised or severely ill patients): trimethoprim/sulfa-methoxazole, cephalexin (Keflex), amoxicillin/clavulanate (Augmentin), or clindamycinĬonservative therapy (warm soaks and elevation) and oral antibiotics (seven to 10 days of trimethoprim/sulfamethoxazole, cephalexin, amoxicillin/clavulanate, or clindamycin) for early infections without abscess formation Incision and drainage in patients with obvious fluid collection and when conservative management is ineffective Topical antibiotics: gentamicin, mupirocin (Bactroban), or topical fluoroquinolones Opportunistic infections in immunocompromised patientsĬonservative therapy (elevation, warm soaks, splint in functional position ) for simple, early, uncomplicated infections without abscess ![]() Pseudomonas, gram-negative bacilli (e.g., Proteus), and anaerobes from exposure to oral flora Staphylococcus aureus and other streptococci are most common ![]() Empiric antibiotics and prompt surgical consultation are indicated to reduce long-term morbidity. Clenched-fist bite wounds result from direct contact of the fist on incisor teeth and are associated with polymicrobial infections. Pyogenic flexor tenosynovitis is a rapidly progressing bacterial infection of the flexor tendon sheaths in the hand, most commonly caused by a penetrating injury to the finger. Deep hand infections include pyogenic flexor tenosynovitis and clenched-fist bite wounds. Herpetic whitlow is caused by herpes simplex virus and typically resolves without intervention. Treatment often involves surgical drainage and empiric oral antibiotics. ![]() A felon is an infection of the distal pulp of the finger. Treatment involves warm soaks, topical antibiotics, and abscess drainage, if indicated. Paronychia, which can be acute or chronic, is an infection or inflammation of the nail fold. Superficial hand infections are more common than deep infections and are typically managed with elevation, warm soaks, splinting in the position of function, analgesics, and empiric antibiotics when indicated. Superficial infections occur in the skin and subcutaneous tissues, whereas deep infections can involve the tendon sheaths, adjacent anatomic compartments, deep fascial planes, bursae, joint spaces, and bones. Acute hand infections are often caused by puncture wounds and are generally classified into superficial or deep infections.
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