J Hand Microsurg 2019; 11(03): 170-174
DOI: 10.1055/s-0039-1688510
Case Report
Society of Indian Hand & Microsurgeons

Continuous Catheter Irrigation for the Treatment of Purulent Tenosynovitis during Two-Stage Flexor Tendon Reconstruction

Megumi Fujita
1   Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
,
Takuji Iwamoto
1   Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
,
Taku Suzuki
1   Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
,
Noboru Matsumura
1   Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
,
Kazuki Sato
1   Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
,
Masaya Nakamura
1   Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
,
Morio Matsumoto
1   Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
› Author Affiliations
Funding None.
Further Information

Publication History

Received: 26 October 2018

Accepted after revision: 19 February 2019

Publication Date:
02 June 2019 (online)

Abstract

Two-stage flexor tendon reconstruction with a silicone rod is useful for restoring the tendon and tendon sheath but sometimes results in infection after the first-stage operation. We experienced a case in which we maintained the reconstructed tendon sheath by replacing an infected silicone rod with a polyvinyl chloride tube, followed by continuous catheter irrigation until the infection subsided. This procedure can effectively deal with infection of a silicone rod during two-stage flexor tendon reconstruction.

 
  • References

  • 1 Hunter JM, Salisbury RE. Flexor-tendon reconstruction in severely damaged hands. A two-stage procedure using a silicone-Dacron reinforced gliding prosthesis prior to tendon grafting. J Bone Joint Surg Am 1971; 53 (05) 829-858
  • 2 Weinstein SL, Sprague BL, Flatt AE. Evaluation of the two-stage flexor-tendon reconstruction in severely damaged digits. J Bone Joint Surg Am 1976; 58 (06) 786-791
  • 3 Pang HN, Teoh LC, Yam AK, Lee JY, Puhaindran ME, Tan AB. Factors affecting the prognosis of pyogenic flexor tenosynovitis. J Bone Joint Surg Am 2007; 89 (08) 1742-1748
  • 4 Neviaser RJ. Closed tendon sheath irrigation for pyogenic flexor tenosynovitis. J Hand Surg Am 1978; 3 (05) 462-466
  • 5 Lille S, Hayakawa T, Neumeister MW, Brown RE, Zook EG, Murray K. Continuous postoperative catheter irrigation is not necessary for the treatment of suppurative flexor tenosynovitis. J Hand Surg [Br] 2000; 25 (03) 304-307
  • 6 Gutowski KA, Ochoa O, Adams Jr WP. Closed-catheter irrigation is as effective as open drainage for treatment of pyogenic flexor tenosynovitis. Ann Plast Surg 2002; 49 (04) 350-354
  • 7 Wehbé MA, Mawr B, Hunter JM, Schneider LH, Goodwyn BL. Two-stage flexor-tendon reconstruction. Ten-year experience. J Bone Joint Surg Am 1986; 68 (05) 752-763
  • 8 Beris AE, Darlis NA, Korompilias AV, Vekris MD, Mitsionis GI, Soucacos PN. Two-stage flexor tendon reconstruction in zone II using a silicone rod and a pedicled intrasynovial graft. J Hand Surg Am 2003; 28 (04) 652-660