Arch Hand Microsurg 2019; 24(1): 1-9  
Analysis for the Factors the Severity of the Inflammatory Hand Lesions in Diabetes Mellitus Patients
In Sook Jang1,2, Hyun Dae Shin3, Myong Hwa Park1, Soo Min Cha3
1College of Nursing, Chungnam National University, Daejeon, Korea, 2Department of Infection Control, Chungnam National University Hospital, Daejeon, Korea, 3Department of Orthopedic Surgery, Chungnam National University School of Medicine, Daejeon, Korea
Correspondence to: Soo Min Cha
Department of Orthopedic Surgery, Chungnam National University School of Medicine, Regional Rheumatoid and Degenerative Arthritis Center, Chungnam National University Hospital, 266 Munhawro, Jung-gu, Daejeon 35015, Korea
TEL: +82-42-338-2480, FAX: +82-42-338-2481, E-mail: smcha@cnu.ac.kr
Received: August 10, 2018; Revised: October 9, 2018; Accepted: November 14, 2018; Published online: March 1, 2019.
© Korean Society for Surgery of the Hand, Korean Society for Microsurgery, and Korean Society for Surgery of the Peripheral Nerve. All rights reserved.

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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.
Keywords: Diabetes mellitus, Pus, Gangrene, Skin graft, Flap


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