synonyms:
Flexor tendon sheath Irrigation and debridement CPT
Flexor tendon sheath Irrigation and debridement Indications
- Septic tenosynovitis, finger, flexor sheath.
Flexor tendon sheath Irrigation and debridement Contraindications
Flexor tendon sheath Irrigation and debridement Alternatives
- Trial of IV antibiotics (if infection caught early or diagnosis uncertain)
Flexor tendon sheath Irrigation and debridement Pre-op Planning
- Ensure 18-gauge angio caths are available
Flexor tendon sheath Irrigation and debridement Technique
- Sign operative site.
- Supine position.
- Transverse incision at the level of the proximal end of the metacarpal in the distal palmar flexion crease.
- Blunt dissection to the flexor sheath preserving the neuromuscular bundles.
- Incise the sheath longitudinally proximal to the A1 pulley.
- Culture
- Insert 18 gauge angio cath under the A1 pulley.
- Second transverse incision (or Bunnel incision) over DIP flexion crease.
- Incise flexor sheath longitudinally, just distal to the A4 pulley.
- Irrigate through the 18 gauge angio cath proximally.
- Consider second 18 gauge angio cath placed in the flexor sheath distally.
- Gentle irrigation with normal saline through the proximal incision should flow out the distal wound.
- Consider leaving angio caths in place and irrigating sheath with normal saline every other hour for 24-48hours.
- Incision are left open and not repaired with suture.
- A light dressing applied.
Flexor tendon sheath Irrigation and debridement Complications
Flexor tendon sheath Irrigation and debridement Follow-up care
- Post-op:
- 7-10 Days:
- 3 Weeks:
- 6 Weeks:
- 2 Months:
- 3 Months:
- 6 Months:
- 1Yr:
Flexor tendon sheath Irrigation and debridement Outcomes
Flexor tendon sheath Irrigation and debridement Review References
