Nikkhah Dariush, Rodrigues Jeremy, Osman Khabab, Dejager Lodewikus
Great Ormond Street Hospital, London, UK.
Hand Surg. 2012;17(2):199-203. doi: 10.1142/S0218810412500190.
We report outcomes and learning points from flexor sheath infection (FSI) cases presenting over one year to a United Kingdom (UK) hand unit. Between August 2009 and August 2010, 16 FSIs were confirmed from operation note findings. Patient age ranged from 12 to 82 years. All patients were posted a quickDASH questionnaire. In all cases, surgery was performed within 24 hours, via distal and palmar incisions, with 0.9% saline irrigation. Seven patients (44%) responded to questionnaires. Of these, most achieved a good functional outcome, with a mean quickDASH of 7.14. Four cases (25%) had no triggering event. Beta-haemolytic streptococcus was cultured in three cases (18%). Its presence was significantly associated with a requirement for multiple operations (p < 0.032), and with prolonged admission of up to nine days (p < 0.009). We suggest that close liaison with microbiology services and early identification of beta-haemolytic streptococcus may predict the need for multiple washouts in FSI.
我们报告了在英国一家手部治疗中心就诊超过一年的屈指肌腱鞘感染（FSI）病例的治疗结果及经验教训。2009年8月至2010年8月期间，根据手术记录结果确诊了16例FSI。患者年龄在12岁至82岁之间。所有患者均收到一份快速残疾调整量表（quickDASH）问卷。所有病例均在24小时内通过远端和掌侧切口进行手术，并用0.9%的生理盐水冲洗。7名患者（44%）回复了问卷。其中，大多数患者获得了良好的功能结果，平均quickDASH评分为7.14。4例（25%）无诱发事件。3例（18%）培养出β-溶血性链球菌。其存在与多次手术需求显著相关（p < 0.032），并与长达九天的延长住院时间相关（p < 0.009）。我们建议与微生物学服务部门密切联系并早期识别β-溶血性链球菌可能预测FSI中多次冲洗的必要性。
