Five-year Analysis of Hand Infections in Plastic Surgery: Clinical Patterns and Risk Factors in a Referral Center from Latin America

Background: Hand infections carry a significant clinical and socioeconomic burden due to the hand’s complex anatomy and its essential role in daily activities. Despite advances in diagnostics and therapy, unfavorable outcomes remain common, particularly in low- and middle-income settings where standardized protocols are scarce. Methods: We conducted a retrospective observational study of 162 patients treated for hand infections between 2017 and 2023 at a secondary-level referral center in Latin America. Demographic, clinical, microbiological, and surgical variables were analyzed. Recurrence of infection at 2-week follow-up was the primary outcome. Statistical analyses included χ 2 tests, t tests, and binary logistic regression. Results: The mean age was 46.9 ± 19.1 years, with a male predominance (71.6%). Infection recurrence occurred in 17.3% of cases. Abscess drainage with secondary closure of the wound was the most frequent procedure (47.2%) and had the lowest recurrence rate (4.1%), whereas primary wound closure showed the highest (41.9%); however, this difference did not reach statistical significance. Staphylococcus aureus was the most frequently isolated organism (21.0%). Infections predominantly involved the right hand (55.6%), particularly flexor zones 4 and 5. Logistic regression analysis found no significant association between recurrence and fever, leukocytosis, or Gram-stain profile. Conclusions: Early surgical drainage remains essential to reduce recurrence. These findings underscore the need for context-adapted treatment protocols for hand infections in Latin American populations.