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In septic tenosynovitis of the hand, subcutaneous abscesses increase risk for second débridement

A subcutaneous abscess was the only presenting factor predictive of a second débridement in a retrospective, single-center study of septic tenosynovitis of the hand.

Researchers examined the cases of all adults who presented at their emergency department from 2007 to 2010 with septic tenosynovitis of the hand. They identified 126 patients; nine were immunosuppressed.

All had community-acquired infections, 34 had a subcutaneous abscess and eight were febrile, according to researchers.

All patients underwent at least one surgical débridement and received concomitant antibiotic therapy for a median of 15 days.

Eighteen patients required at least one additional surgical debridement.

Infections were cured on the first attempt in all but four cases.

Researchers found that only two factors were significantly associated with a subsequent surgical débridement: abscess and longer duration of antibiotic therapy.

“The next step in developing an evidence-based treatment approach to this serious infection is to undertake a randomized trial to evaluate the necessity for subsequent débridement,” the researchers concluded. – by Abigail Sutton

Disclosure: The researchers reported no relevant financial disclosures.