Kreutz-Rodrigues Lucas, Tunaboylu Mehmet Furkan, Moran Steven L
From the Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, MN.
Plast Reconstr Surg Glob Open. 2025 Jan 14;13(1):e6451. doi: 10.1097/GOX.0000000000006451. eCollection 2025 Jan.
Pyogenic flexor tenosynovitis (PFT), also known as septic or suppurative flexor tenosynovitis, is a closed-space infection of the hand's flexor tendon sheath that necessitates timely diagnosis and treatment. The treatment consists of antibiotic therapy often combined with prompt surgical treatment. The most common surgical approach is the closed irrigation technique, which involves inserting a 16-gauge angiocatheter in the proximal aspect of the flexor tendon sheath, leaving the distal end of the Brunner incision open during the irrigation process. However, this method has its own challenges, such as catheter bending and kinking, thereby obstructing the fluid irrigation process and prolonging the operative duration. Instead, we propose the use of a rigid plastic facial fat grafting cannula, which is coupled to a 50-mL syringe with 0.9% saline solution. The cannula is placed at the level of the A1 pulley, and irrigation is easily performed. This simplifies this process by maintaining adequate fluid outflow through the flexor tendon sheath.
化脓性屈指肌腱腱鞘炎(PFT),也称为脓性或化脓性屈指肌腱腱鞘炎,是手部屈指肌腱鞘的一种闭合性感染,需要及时诊断和治疗。治疗包括抗生素治疗,通常还需及时进行手术治疗。最常见的手术方法是闭合冲洗技术,即在屈指肌腱鞘近端插入一根16号血管造影导管,冲洗过程中保留布鲁纳切口远端开放。然而,这种方法有其自身的挑战,如导管弯曲和扭结,从而阻碍液体冲洗过程并延长手术时间。相反,我们建议使用一种刚性塑料面部脂肪移植套管,它与一个装有0.9%生理盐水的50毫升注射器相连。将套管置于A1滑车水平,冲洗操作简便。通过保持屈指肌腱鞘有足够的液体流出,简化了这一过程。