Kardestuncer Mitra, Kardestuncer Tarik
University of Chicago, Chicago, IL.
Orthopedic Partners, North Franklin, CT.
J Hand Surg Glob Online. 2022 Feb 12;4(3):153-155. doi: 10.1016/j.jhsg.2022.01.008. eCollection 2022 May.
Open trigger finger release is generally performed in the operating room in an outpatient setting. Its complication rate widely varies between 1% and 43%. Our goal was to determine whether performing this surgery in the clinic is a safe and viable alternative to performing this surgery in the operating room.
All open trigger finger releases performed at our clinic between 2015 and 2019 were retrospectively reviewed. Each surgery was performed by the same fellowship-trained hand surgeon using a standard open technique with an Esmarch tourniquet and without the use of epinephrine. Five hundred twenty seven finger releases were performed in 514 patients. Complications were defined as signs or symptoms requiring further treatment.
There were 33 documented complications in the 527 fingers (6.3%). The most common complications were minor wound complications, including 17 (3.2%) with localized cellulitis, 2 (0.4%) with a superficial infection, 4 (0.8%) with stitch abscesses, and 5 (0.9%) with wound dehiscence. All minor complications resolved quickly with oral antibiotics and supportive care. Five patients (0.9%) required further operative management. Of these 5, 2 (0.4%) had a deep infection, 1 had chronic dehiscence, and 2 (0.4%) required flexor tenosynovectomy for persistent pain and stiffness.
Patients who undergo open trigger finger release surgery in the clinic have complication rates similar to reported complication rates of surgery performed in the operating room.
Performing open trigger finger surgery in the office is safe. We continue to perform this surgery during the coronavirus disease 2019 pandemic, when access to operating rooms and personal protective equipment is limited.
开放性扳机指松解术通常在门诊手术室进行。其并发症发生率在1%至43%之间广泛波动。我们的目标是确定在诊所进行该手术是否是在手术室进行该手术的安全可行替代方案。
回顾性分析2015年至2019年在我们诊所进行的所有开放性扳机指松解术。每次手术均由同一位接受过 fellowship 培训的手外科医生使用标准开放技术,采用 Esmarch 止血带且不使用肾上腺素进行。共对514例患者进行了527次手指松解术。并发症定义为需要进一步治疗的体征或症状。
527例手指手术中有33例记录在案的并发症(6.3%)。最常见的并发症是轻微伤口并发症,包括17例(3.2%)局部蜂窝织炎、2例(0.4%)浅表感染、4例(0.8%)缝线脓肿和5例(0.9%)伤口裂开。所有轻微并发症通过口服抗生素和支持治疗迅速得到解决。5例患者(0.9%)需要进一步手术处理。其中,2例(0.4%)发生深部感染,1例有慢性伤口裂开,2例(0.4%)因持续疼痛和僵硬需要进行屈指肌腱鞘切除。
在诊所接受开放性扳机指松解手术的患者并发症发生率与在手术室进行手术报告的并发症发生率相似。
在办公室进行开放性扳机指手术是安全的。在2019年冠状病毒病大流行期间,当手术室和个人防护设备的获取受到限制时,我们继续进行该手术。