[Negative pressure therapy as complementary treatment in tropical diabetic hand syndrome].

Abstract

Background: Diabetic hand syndrome is a complication of diabetes mellitus that is rarely described in Mexico. It covers a wide spectrum of nervous, tendinous and infectious disorders. The tropical variant of the disease is described as a necrotizing infection in the upper extremity, generally secondary to superficial trauma. Treatment includes metabolic control, antibiotics and different surgical techniques. Currently, complementary therapies include surgical debridement, flap reconstruction, negative pressure therapy, larval debridement, and stem cell grafting. The objective was to describe negative pressure therapy (NPT) as an adjunctive treatment for a case of tropical diabetic hand syndrome (TDHS) complicated by abscess and compartment syndrome, and we also made a literature review.

Clinical case: 50-year-old male patient with diabetic hand syndrome complicated by abscess and compartment syndrome. Fasciotomy and surgical drainage were performed, complementing the treatment with negative pressure therapy. After 10 days of complementary therapy and 20 more days of follow-up, the patient presented adequate remission.

Conclusion: The use of NPT in the treatment of TDHS helped to limit the infection damage, and allowed the patient to be monitored on an outpatient basis, reducing his hospital stay.