A systematic review of the management of acute pyogenic flexor tenosynovitis.

Abstract

UNLABELLED:

Pyogenic flexor tenosynovitis (PFT) is an aggressive closed-space infection that can result in severe morbidity. Although surgical treatment of pyogenic flexor tenosynovitis has been widely described, the role of antibiotic therapy is inadequately understood. We conducted a literature review of studies reporting on acute pyogenic flexor tenosynovitis management. A total of 28 case series articles were obtained, all of which used surgical intervention with varied use of antibiotics. Inconsistencies among the studies limited summative statistical analysis. Our results showed that use of antibiotics as a component of therapy resulted in improved range of motion outcomes (54% excellent vs. 14% excellent), as did using catheter irrigation rather than open washout (71% excellent vs. 26% excellent). These studies showed benefits of early treatment of pyogenic flexor tenosynovitis and of systemic antibiotic use. As broad-spectrum antibiotics have changed the management of other infectious conditions, we must more closely evaluate consistent antibiotic use in pyogenic flexor tenosynovitis management.

LEVEL OF EVIDENCE:

Therapeutic, Level III.

• Authors: A M Giladi, S Malay, K C Chung
• Journal: The Journal of hand surgery, European volume (J Hand Surg Eur Vol) Vol. 40 Issue 7 Pg. 720-8 (Sep 2015) ISSN: 2043-6289 [Electronic] England
• PMID: 25670687 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review, Systematic Review)
• Copyright: © The Author(s) 2015.

Chemical References

• Anti-Bacterial Agents

Topics

• Anti-Bacterial Agents (therapeutic use)
• Catheters
• Fingers (surgery)
• Humans
• Physical Therapy Modalities
• Range of Motion, Articular
• Soft Tissue Infections (therapy)
• Tenosynovitis (microbiology, therapy)
• Therapeutic Irrigation