Treatment of digital pyogenic flexor tenosynovitis: single open debridement, irrigation, and primary wound closure followed by antibiotic therapy

Hohendorff, B.; Sauer, H; Biber, F.; Franke, Jöerg; Spies, Claudia; Müller, Lars Peter; Ries, Christian

doi:10.1007/s00402-016-2587-5

Cited by 12 publications

(9 citation statements)

References 18 publications

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“…It is clear that it is not American authors who have resistance or difficulty in declaration of LOE. While the current review is focused on the J Hand Surg Am and J Hand Surg Eur publications, several articles have been published reporting the LOE in other journals (Andersson et al., 2018; Boretto et al., 2019; Boyer et al., 2019; Ehrl et al., 2016; El Amiri et al., 2019; Frueh et al., 2014; Fujihara et al., 2018; Goorens et al., 2018; Hohendorff et al., 2017; 2018; Huttin et al., 2018; Kamphuis et al., 2019; Karakaplan et al., 2019; Ma et al., 2017; Mulders et al., 2017; Rijnja et al., 2017; Robinson et al., 2017; Tang et al., 2017; Thorkildsen and Rokkum, 2019; Uluyardimci et al., 2019; van Zyl et al., 2019; Wang et al., 2017; Yeo et al., 2015). These journals included Hand Surgery and Rehabilitation, Archives of Orthopaedic and Trauma Surgery and Journal of Plastic Surgery and Hand Surgery .…”

Section: Discussionmentioning

confidence: 99%

Surgeon level of expertise reported in Journal of Hand Surgery (American Volume) and (European Volume) publications

Massel

Lezak

Summers

et al. 2020

J Hand Surg Eur Vol

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The purpose of the study was to evaluate the trend in documentation of surgeon level of expertise among the Journal of Hand Surgery (American Volume) and the Journal of Hand Surgery (European Volume) publications. A review of Journal of Hand Surgery (American Volume) and Journal of Hand Surgery (European Volume) databases for level of expertise between January 2015 and October 2019 was performed. Of 1042 articles identified, all 115 (20%) reporting level of expertise were published in Journal of Hand Surgery (European Volume). Since 2015, there has been an increase in reported level of expertise in Journal of Hand Surgery (European Volume) (2015: 8 (7%); 2016: 15 (13%); 2017: 22 (19%); 2018: 28 (24%); 2019: 42 (37%)). In the same period, no publications have reported level of expertise in Journal of Hand Surgery (American Volume). Documenting level of expertise may provide readers with additional information for incorporation of novel techniques into their practices. It may identify procedures that require a baseline level of expertise for effective performance. Further evaluation of level of expertise criteria may improve the reliability of the numeric scale, while widespread adoption of this scale will allow future outcome analysis by level of expertise.

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Section: Discussionmentioning

confidence: 99%

Surgeon level of expertise reported in Journal of Hand Surgery (American Volume) and (European Volume) publications

Massel

Lezak

Summers

et al. 2020

J Hand Surg Eur Vol

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“…Hohendorff et al had similar success in their series of 22 patients with a short course of IV antibiotics transitioned to oral antibiotics. They suggested a surgically treated infection no longer needs prolonged postoperative antibiotic treatment [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Parenteral and Per-Oral Antibiotic Usage in Pyogenic Flexor Tenosynovitis: A Retrospective Study

Frizzell¹,

Galvis²,

Bhandari³

2022

Cureus

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IntroductionPyogenic flexor tenosynovitis (PFT) is a common hand infection that can cause significant morbidity. Although treatment involves surgical debridement and inpatient intravenous (IV) antibiotics, there is a paucity of literature guiding antibiotic use. This study aims to determine if the use of postoperative outpatient oral antibiotics leads to poor outcomes compared to IV antibiotics given in an institutional setting. MethodsA retrospective review of 110 patients treated post-operatively with either outpatient oral or inpatient IV antibiotics at our institution from 2016-2019 was performed. All patients underwent surgical debridement. Primary outcomes analyzed included readmission, repeat surgery, and amputation. Clinical parameters including age, diabetes, smoking, duration of symptoms, involvement of surrounding structures (felon, dorsal abscess, osteomyelitis, septic arthritis), culture growth, Michon classification, and duration of antibiotics were analyzed as possible risk factors for poor outcome. The level of evidence of this study is Level 3 Retrospective Cohort Study. ResultsSeventy-five patients were treated with outpatient oral antibiotics and 35 patients were treated with inpatient IV antibiotics. The oral antibiotics group received antibiotics for 13.1 +/-9.9 days compared to 18.1 +/-10.4 days in the IV antibiotic group. Patients in the oral antibiotic group had a significantly shorter length of hospitalization at 0.6 +/-1.8 days compared to 3.6 +/-1.8 days in the IV antibiotic group. The readmission rate for the oral antibiotic group was 10.7% compared to 5.7% in the IV antibiotic group. This difference was not statistically significant except in patients who had involvement in surrounding structures. There was no significant difference in repeat surgeries or amputations between the groups. ConclusionsThe use of outpatient oral antibiotics after surgical debridement for PFT does not significantly increase rates of readmission, repeat surgery, or amputation, except in cases with the involvement of surrounding structures. On subgroup analysis, anaerobic infection and diabetes were significantly associated with amputations. Post-operative oral antibiotics and immediate discharge may be considered for PFT after adequate surgical debridement with close outpatient follow-up in the absence of surrounding structure involvement and diabetes.

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“…Liegt eine deutliche Synovialitis vor, besteht ein Stadium 2b. Mittlerweile gibt es einige Studien, die belegen, dass auch hierfür diese begrenzten Eröffnungen und Spülungen ausreichend sind [24][25][26][27].…”

Section: Operation Im Stadium 1 Und 2aunclassified

“…Die pflegerisch und technisch aufwendige kontinuierliche Katheterspülung der Beugesehnenscheide [36] wird auch von uns zunehmend weniger eingesetzt [24][25][26]37]. Die Ergebnisse unterscheiden sich nicht von der einzeitigen Operation.…”

Section: Kontinuierliche Katheterspülungunclassified

Infektionen der Beugesehnenscheide

Langer

Grünert

Unglaub

et al. 2021

Handchir Mikrochir Plast Chir

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ZusammenfassungDie Infektionen der Beugesehnenscheide gehören immer noch zu den gravierendsten und folgenschwersten Infektionen an der Hand. Wenn die typischen Kardinalzeichen einer Beugesehnenscheideninfektion nach Kanavel bestehen, sollte unverzüglich die Indikation zur Operation gestellt werden. Die Folgeschäden einer verzögerten oder verspäteten Operation mit enormen Bewegungseinschränkungen der Finger durch Zerstörung der Gleitschichten und massiven Verklebungen, die sich später häufig nur noch wenig durch Handtherapie verbessern lassen, sind so gravierend, dass sich konservative Therapieversuche nur sehr schwer rechtfertigen lassen. Das schnelle chirurgische Eingreifen und die frühzeitige Eröffnung und Entlastung sowie die Spülung der Sehnenscheide kann die Erkrankung, die Zerstörung der Gleitschichten sowie die starken Schmerzen fast augenblicklich beenden. Wichtig sind ein schnelles Erkennen und ein schnelles Handeln. Bei frühzeitiger Intervention kann häufig die normale Handfunktion komplett wiederhergestellt werden.

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Treatment of digital pyogenic flexor tenosynovitis: single open debridement, irrigation, and primary wound closure followed by antibiotic therapy

Cited by 12 publications

References 18 publications

Surgeon level of expertise reported in Journal of Hand Surgery (American Volume) and (European Volume) publications

Surgeon level of expertise reported in Journal of Hand Surgery (American Volume) and (European Volume) publications

A Comparison of Parenteral and Per-Oral Antibiotic Usage in Pyogenic Flexor Tenosynovitis: A Retrospective Study

Infektionen der Beugesehnenscheide

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