Surgery
Suppurative flexor tendon tenosynovitis surgery has the aim of releasing pus to prevent adhesions. One effective way of doing this is:
- the distal palmar crease is incised into in the affected digit
- the proximal end of the flexor tendon sheath is identified
- the sheath is divided longitudinally for a short distance, any fluid emanating should be cultured
- a small bore nylon tube is passed down the sheath and secured proximally
- at the distal flexor crease of the affected digit, a small lateral incision is made
- the tendon sheath is carefully identified and incised to create an second, distal opening
- normal saline is passed down the nylon tube and emerges out of the distal hole; this continues until the irrigation fluid is clear
- at intervals, irrigation is continued for at least 2 days
Intravenous, the oral antibiotics are recommended for a week. Physiotherapy should commence as soon as possible after removal of the catheter.
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