Felon L03.019 681.01

ICD-9	Classification / Treatment / I&D
Etiology / Epidemiology / Natural History	Associated Injuries / Differential Diagnosis
Anatomy	Complications
Clinical Evaluation	Follow-up Care
Xray / Diagnositc Tests	Review References

synonyms:

Felon ICD-10

Felon ICD-9

Felon Etiology / Epidemiology / Natural History

Felon Anatomy

Felon Clinical Evaluation

Intense throgging pain and swelling of the entire finger pulp. Usually associated with penetrating trauma

Felon Xray / Diagnositc Tests

A/P and lateral of affected digit. Usually normal, but indicated to rule out foreign body and osteomyelitis.

Felon Classification / Treatment

Acute: if identify early a short trial of PO antibiotics, elevation and betadine soaks is indicated as long as not fluctuance is identified. Dicloxacillin 500 mg PO q6h, or Nafcillin 1-2 g IV q4-6h, or Clindamycin 300 mg PO q6h, or Cephalexin 500 mg PO q6h, or Cefazolin 1 g IV q8h, or Erythromycin 500 mg PO q6h
MRSA is becoming increaseingly prevalent, especially in hand infections. Consider Bactrim DS +/- rifampin. If group A streptococcus is strongly suspected add Keflex
Subacute / Chronic: any felon with abcess formation of the fails to improve with non-operative treatment should undergo incision and drainage.

Felon Felon I&D Technique

Digital block.
Prep and drape in standard sterile fashion.
Midvolar or high lateral longitudinal incision based on area of fluctuance or maximal tenderness.
Take anaerobic, aerobic cultures and gram stain.
Use curved hemstat to break-up and loculations. Avoid deep proximal probing to prevent comtanination of the flexor tendon sheath.
Irrigate.
Pack wound loosely with gauze.

Felon Associated Injuries / Differential Diagnosis

Felon Complications

Felon Follow-up Care

Felon Review References