Department of Hand and Reconstructive Microsurgery, Singapore General Hospital, Singapore.
Tech Hand Up Extrem Surg. 2023 Dec 1;27(4):220-224. doi: 10.1097/BTH.0000000000000440.
Septic arthritis of the metacarpophalangeal joint (MCPJ) compromises 9% of hand infections in Singapore. Common surgical treatment is open arthrotomy and joint washout. The wound is often left open for drainage postoperatively. Repeated debridement and secondary closure are frequently needed after the index surgery. We describe a method of continuous catheter irrigation of septic MCPJ joint using an infant feeding catheter. This method provides great infection clearance to avoid repeated debridement and allows primary closure of the wound to avoid secondary closure. This method also significantly reduces postoperative pain so that to facilitate early mobilization of the joint, which is crucial for functional recovery. We illustrate the techniques of this procedure and key points of postoperative management in the ward with case examples to demonstrate its simplicity, safety, and efficacy in treating MCPJ septic arthritis.
掌指关节（MCPJ）化脓性关节炎占新加坡手部感染的 9%。常见的手术治疗是切开关节和关节冲洗。术后伤口常敞开引流。指数手术后通常需要多次清创和二期缝合。我们描述了一种使用婴儿喂养管对化脓性 MCPJ 关节进行持续导管灌洗的方法。这种方法可提供良好的感染清除效果，避免反复清创，并可使伤口一期闭合，避免二期缝合。这种方法还显著减轻术后疼痛，从而便于关节早期活动，这对于功能恢复至关重要。我们通过病例示例展示了该手术的技术和病房内的术后管理要点，以证明其治疗 MCPJ 化脓性关节炎的简单性、安全性和有效性。
