Die Spül-Saug-Drainage zur Behandlung von Infektionen der Beugesehnenscheide an der Hand

Abstract

Treatment of pyogenic flexor tenosynovitis within the osteofibrous channel of the thumb and finger by insertion of a closed irrigation system. Pyogenic tenosynovitis of the flexor tendons of the hand. Necrosis of the flexor tendons or flexor tendon sheath, gangrene of the finger, extensive loss of soft tissue. Insertion of a flexible irrigation catheter via a guide wire into the flexor tendon sheath and a vacuum suction drain into the finger or the palm of the hand. Extensive exploration of the flexor tendon sheath is not mandatory. On days 0-3 continuous irrigation, on day 4 change of the irrigation catheter to suction, on day 5 removal of the irrigation catheter, on day 6 removal of the suction drain, on day 7 start of exercise. Irrigation volume: about 500-1500ml/24h isotonic solution. Of 35patients treated for flexor tenosynovitis by closed irrigation, 33were reviewed. There were 19male patients and 14female patients. The average age at the time of surgery was 51 (8-85)years. Hospital stay was 8.9 (3-26)days on average. At the time of follow-up, the average grip strength was 84% (23-163%) of the unaffected side. Pain at rest was 0.2 (0-4), pain during exercise 1.2 (0-8) on the analogue scale, the DASH score was 16.8 (0-58) points. According to the rating system for flexor tendon function, there were one poor, one fair, five good, and 26 excellent results.