Deep space infection of the palm

　　Palmar intertriginous infection is often caused by the spread of tenosynovitis of the middle finger and ring finger, and thenar space infection is caused by the infection of the index finger tenosynovitis. It can also be infected due to direct injury. The pathogenic bacteria are mostly Staphylococcus aureus.

　　Deep palmar space infection is divided into palmar intertriginous infection and thenar space infection. The former is known as 'Tuopan Yan', 'Shouxin Du', and 'Zhangxin Du' in traditional Chinese medicine, and the latter is known as 'Hu kou Yan' and 'He Gu Ju', which is a relatively serious acute hand purulent infection.

　　The book 'Yangke Zhunshen' says: 'The palm is infected with toxins, red and painful, commonly known as 'Bing Chuan Pan', also known as 'Chuan Ku Tian She', and the book 'Zhengzhi Zhunshen' says: 'The mouth of the tiger is infected with toxins, red and painful, named 'Tai Gu Ju'. The characteristic is swelling of the palm, disappearance of the normal concave depression of the palm center, marked tenderness, and marked swelling, tenderness of the thenar eminence and thumb, but the palm pit remains concave. The cause is that the skin at the thought is tough, although it also becomes purulent, it is not easy to penetrate outward, so it is easy to damage the tendons and bones, affecting the function of the affected hand, and even causing disability.

　　If the infection is not treated in time, it will cause various serious complications. Staphylococcal sepsis is a common cause of death. Typical sepsis cases have persistent high fever and sometimes shock. At the same time, staphylococci can spread through the blood and cause abscesses in internal organs (such as the lungs) and bone infections (osteomyelitis) and infections of the endocardium and heart valves (endocarditis).

　　1. Palmar intertriginous infection

　　The normal concave depression of the palm center disappears, becomes prominent, the skin becomes tense and pale, with marked tenderness. The middle finger, ring finger, and little finger are in a semi-flexed position, and passive extension of the fingers can cause severe pain. Severe edema on the back of the hand. There are systemic symptoms such as high fever, headache, rapid pulse, and increased white blood cell count.

　　Treatment can use high-dose antibiotics. Local early treatment is the same as that for purulent phalangeal炎. If there is no improvement in a short period of time, it should be incised and drained early. The web between the middle finger and ring finger is incised longitudinally, the incision should not exceed the palmar transverse crease on the ulnar side to avoid injury to the palmar arch. Use hemostats to separate the subcutaneous tissue, and you can reach the palm's intermediate space. You can also make a small transverse incision at the palmar distal transverse crease at the corresponding position of the ring finger to enter the palm's intermediate space.

　　2. Palmar space infection

　　The metacarpal arch and thumb web are明显 swollen with tenderness, but the palm pit remains concave; the thumb is abducted slightly flexed, the index finger semi-flexed, with limited movement, especially the thumb cannot oppose the palm. Accompanied by systemic symptoms.

　　After being pierced by a hand, do not be concerned about the size of the wound and the amount of bleeding. What is important is to judge whether there is a broken needle residual in the wound. If there is, the first thing to do is to try to pull it out. Apply alcohol around the wound to disinfect, and use a pair of forceps that have been burned or disinfected with alcohol to try to pull out the needle intact. If the exposed part of the needle is very short and the forceps cannot hold it, use a disinfected needle to pick the outer skin of the wound, appropriately expand the wound, so that the needle is as exposed as possible, and gently pull it out. After confirming that there is no needle, gently squeeze the wound to expel the blood stasis, reducing the chance of the wound being infected again. Finally, disinfect the wound around the wound with iodine alcohol once, alcohol twice, and wrap it with a disinfected gauze. If you are still not sure, you can take Neomycin to prevent inflammation.

　　The diagnosis of deep palm space infection not only relies on clinical manifestations, but also the relevant auxiliary examinations are indispensable. The smear or culture of related specimens (blood, pus, etc.) can find the pathogenic bacteria.

　　1. What foods are good for the body for deep palm space infection?

　　Eat light and nutritious food, pay attention to dietary balance.

　　2. What foods should be avoided for deep palm space infection?

　　Avoid spicy and刺激性 food, avoid greasy, fried, and smoked food.

　　(The above information is for reference only, please consult a doctor for details)

　　1. For palm inter-space infection:Treatment can use high-dose antibiotics. Local early treatment is the same as that for purulent phalangeal炎. If there is no improvement in a short period of time, early incision and drainage should be performed. Make a longitudinal incision between the middle and ring fingers of the web, and the incision should not exceed the distal transverse crease of the palm to avoid injury to the palmar arch. Use hemostats to stretch the subcutaneous tissue, and you can reach the palm inter-space. You can also make a small transverse incision at the common distal transverse crease relative to the ring finger to enter the palm inter-space.

　　2. For thenar space infection:General treatment is the same as that for interdigital space infection. The incision for drainage can be made directly at the most swollen and fluctuating part of the thenar eminence. It can also be made at the web between the thumb and index finger (‘Houkou’), or a longitudinal incision can be made on the radial side of the second metacarpal on the back of the hand.