Infections involving hand and forearm:
Simple soft tissue infections of the extremity will be referred by UKMD’s to the ER and managed by the ER physicians with I & D of subcutaneous abscess and admission to Hospitalist service if necessary. If advanced infection / abscess above the deep fascia or necrotizing fasciitis and OR is possibly needed, an Acute Care Surgery Consult is established. The Hand Service will not admit or manage these patients. If a Plastic Surgery consult is needed for subsequent wound coverage, that consult can be placed once the active infection is managed.
Simple guidance is below:
Cellulitis->HM
Simple abscess-> ED I&D, admit HM (if needed)
Complex abscess, above fascia-> ACS, admit ACS
NSTI-> ACS, admit ACS
Sub-fascial abscess-> Hand, admit HM (if needed)
Forearm compartment syndrome-> Hand
True hand-> Hand
