You are here

Flexor tendon sheath Irrigation and debridement 26020

 
CPT Technique
Indications Complications
Contraindications Follow-up Care / Rehab Protocol
Alternatives Outcomes
Pre-op Planning / Case Card Review References

synonyms:

 Flexor tendon sheath Irrigation and debridement  CPT

Flexor tendon sheath Irrigation and debridement  Indications

  • Septic tenosynovitis, finger, flexor sheath. 

 Flexor tendon sheath Irrigation and debridement  Contraindications

  •  

Flexor tendon sheath Irrigation and debridement  Alternatives

  • Trial of IV antibiotics (if infection caught early or diagnosis uncertain)

Flexor tendon sheath Irrigation and debridement  Pre-op Planning

  • Ensure 18-gauge angio caths are available

Flexor tendon sheath Irrigation and debridement  Technique

  • Sign operative site.
  • Supine position.
  • Transverse incision at the level of the proximal end of the metacarpal in the distal palmar flexion crease. 
  • Blunt dissection to the flexor sheath preserving the neuromuscular bundles. 
  • Incise the  sheath  longitudinally proximal to the A1 pulley. 
  • Culture
  • Insert 18 gauge angio cath  under the A1 pulley.
  • Second transverse incision (or Bunnel incision) over DIP flexion crease.
  • Incise flexor sheath  longitudinally, just distal to the A4 pulley.
  • Irrigate through the 18 gauge angio cath proximally.
  • Consider  second 18 gauge angio cath placed in the flexor sheath distally. 
  • Gentle irrigation with normal saline through the proximal incision should flow out the distal wound.
  • Consider leaving angio caths  in place and irrigating sheath with normal saline every other hour for 24-48hours. 
  • Incision are left open and not repaired with suture.
  • A light dressing applied.

Flexor tendon sheath Irrigation and debridement  Complications

Flexor tendon sheath Irrigation and debridement  Follow-up care

  • Post-op:
  • 7-10 Days:
  • 3 Weeks:
  • 6 Weeks:
  • 2 Months:
  • 3 Months:
  • 6 Months:
  • 1Yr:

Flexor tendon sheath Irrigation and debridement  Outcomes

Flexor tendon sheath Irrigation and debridement  Review References

 

 

Disclaimer

The information on this website is intended for orthopaedic surgeons.  It is not intended for the general public. The information on this website may not be complete or accurate.  The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care".  While the information on this site is about health care issues and sports medicine, it is not medical advice. People seeking specific medical advice or assistance should contact a board certified physician.  See Site Terms / Full Disclaimer