Surgical drainage of dorsal subcutaneous abscess of the hand

The dorsal skin of the hand is loosely anchored to the underlying tissue, which allows the spread of infection into two potential spaces: the dorsal subcutaneous space, which is superficial to the extensor tendons, and the dorsal subaponeurotic space, which is deep to the extensor tendons.
Panels A through C demonstrate surgical drainage of a subcutaneous abscess of the dorsum of the right hand:
(A) Preoperative appearance.
(B) Intraoperative appearance.
(C) Postoperative appearance.
Panel D shows a more extensive dorsal subaponeurotic abscess. Patients who require extensive debridement may need additional surgical procedures to resurface the resulting soft tissue defect.