The Outpatient Treatment of Pyogenic Flexor Tenosynovitis

Historically, pyogenic flexor tenosynovitis has been treated with surgical debridement followed by
hospitalization and administration of intravenous antibiotics. Recently, hand surgeons have treated
this disorder on an outpatient basis. We retrospectively reviewed 37 patients with pyogenic flexor
tenosynovitis who were managed as outpatients. Each patient underwent operative irrigation and
debridement with intraoperative catheter irrigation. Postoperatively, patients were treated with outpatient
intravenous antibiotics. Conversion to oral antibiotics was based on intraoperative culture results. Using
this protocol, the average length of intravenous antibiotic usage was 3.5 days. Of the 28 patients
with documented follow-up, 27 resolved the infection and one had a recurrence of the infection. No
amputations were noted. Total active motion measurement was obtained from 15 patients showing good
or excellent results in 14 of 15 patients. This preliminary retrospective case cohort suggests favorable
results with outpatient treatment of pyogenic flexor tenosynovitis. (Journal of Surgical Orthopaedic
Advances 14(2):92–95, 2005)
Key words: flexor tendon, infection, pyogenic flexor tenosynovitis, tenosynovitis