title: Treatment of digital pyogenic flexor tenosynovitis: single open debridement, irrigation, and primary wound closure followed by antibiotic therapy.
abstract: BACKGROUND
  Digital pyogenic flexor tenosynovitis requires fast, aggressive treatment. Although this infection occurs frequently, treatment consensus is lacking.
  
  
  METHODS
  Between 2011 and 2015, 22 patients with acute pyogenic flexor tenosynovitis were treated with a single open debridement followed by irrigation; the incision was closed and a 10-day antibiotic course was administered. The average incision-to-suture time was 25 min, and the average hospital stay was 4 days. Recovery was uncomplicated for 20 patients, while two were reoperated, one due to germ resistance and the other due to necrotizing fasciitis. At an average of 30 month postoperatively, 21 of the 22 patients were available for follow-up. The affected finger was inspected, and sensibility, range of motion, and grip force were compared with the opposite side, and the DASH score was determined. Each patient documented pain in the affected finger at rest and during activity, and rated overall satisfaction with the treatment on a visual analogue scale.
  
  
  RESULTS
  Almost all patients were free of pain at follow-up and very satisfied. Compared to the contralateral side, each of the affected fingers had the same range of motion and sensibility. Grip force was similar on both sides. The average DASH score was 35 points.
  
  
  CONCLUSIONS
  A single open debridement with irrigation and primary wound closure followed by 10 days of antibiotic treatment resolved uncomplicated pyogenic flexor tenosynovitis. After 2 and a half years, the treatment yielded high patient satisfaction with neither functional nor subjective impairment of the affected finger.
authors: Abteilung für Hand-, Ästhetische und Plastische Chirurgie, Elbe Klinikum Stade, Stade, Germany. bernd.hohendorff@hotmail.com.
authors: Bernd
authors: B
authors: Hohendorff
authors: Abteilung für Hand-, Ästhetische und Plastische Chirurgie, Elbe Klinikum Stade, Stade, Germany.
authors: H
authors: H
authors: Sauer
authors: Abteilung für Hand-, Ästhetische und Plastische Chirurgie, Elbe Klinikum Stade, Stade, Germany.
authors: F
authors: F
authors: Biber
authors: Klinik für Unfallchirurgie und Orthopädie, Elbe Klinikum Stade, Stade, Germany.
authors: J
authors: J
authors: Franke
authors: Handchirurgie, Vulpius Klinik, Bad Rappenau, Germany.
authors: C K
authors: CK
authors: Spies
authors: Unfall-, Hand- und Ellenbogenchirurgie, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum zu Köln, Cologne, Germany.
authors: L P
authors: LP
authors: Müller
authors: Unfall-, Hand- und Ellenbogenchirurgie, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum zu Köln, Cologne, Germany.
authors: C
authors: C
authors: Ries
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D003646:Debridement / Q000009:adverse effects; D019115:Fasciitis, Necrotizing / Q000601:surgery; D005260:Female; D005385:Fingers / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D016059:Range of Motion, Articular; D012086:Reoperation; D013530:Surgical Wound Infection / Q000601:surgery; D013717:Tenosynovitis / Q000188:drug therapy / Q000601:surgery*; D007507:Therapeutic Irrigation; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic therapy; Finger; Primary wound closure; Pyogenic flexor tenosynovitis