What is included in postoperative care for infectious flexor tenosynovitis?

Updated: Aug 27, 2018
  • Author: Mark R Foster, MD, PhD, FACS; Chief Editor: Harris Gellman, MD  more...
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Answer

In the case of infectious FT, approximately 48 hours after surgery, remove the dressing, splint, and drains, and inspect the wounds. Initiate active and passive ROM exercises, as well as soaks or whirlpool treatments. Usually, a removable splint is fabricated and elevation is continued.

For persistent infection, repeat operative débridement may be required. IV antibiotics should continue for an additional 48-72 hours; the length of IV antibiotic treatment is determined by the culture and sensitivity results and by specific patient factors. The switch from IV to oral antibiotics should be based not only on culture results but also on the clinical examination and patient progress. Oral antibiotics should be continued for 5-14 days, depending on the following:

  • Intraoperative findings
  • Comorbidities
  • Organism isolated
  • Response to therapy

Generally, the wounds should be left open so they can heal promptly by secondary intention. Delayed primary closure is not needed.


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