Purulent Tenosynovitis

　　Suppurative tenosynovitis is often caused by incisions on the palmar transverse ridges of the fingers. The palm of the hand has a thick keratinized layer of skin, a thick subcutaneous fat pad, and many vertical fiber small beams that connect the skin with the palmar fascia, tenosynovium, and phalangeal periosteum, making the palmar skin not easy to slide, which is beneficial for pinching and grasping actions. However, when there is a skin defect, it is not easy to directly suture, and it often requires skin grafting or flap transfer to cover the wound. The papillary layer of the skin of the distal phalanx has a very rich number of sensory nerve endings and receptors, with a very sensitive sense.

　Suppurative tenosynovitis requires active anti-inflammatory treatment, incision and drainage. If there is no improvement even after active treatment, and if there is no early decompression incision, tendons may be necrotic..

　　Suppurative tenosynovitis is a severe hand infection with rapid onset. When the pus has not yet formed in the sheath, obvious systemic symptoms may appear, such as high fever, chills, nausea, vomiting, and increased white blood cells.

　　Typical symptoms include: the affected finger is uniformly red and swollen, resembling a sausage; the finger is in a semi-flexed state, and active and passive extension of the finger can cause severe pain, with marked tenderness along the entire sheath.

　　The prevention of suppurative tenosynovitis mainly involves preventing injuries, paying attention to safe operations in work and life, and actively treating inflammation around the tenosynovitis. In short, it is to actively treat the primary disease and discover and treat it early.

　　Suppurative tenosynovitis is mostly caused by incisions on the palmar transverse ridges of the fingers, while blood源性 infections are less common. The sheath is rich in synovial fluid, moist and less bloody, providing favorable conditions for infection. Once infection occurs, inflammation quickly spreads to the entire sheath. So what examinations should patients with suppurative tenosynovitis undergo? The following introduces the examinations that should be done for suppurative tenosynovitis:

　　1. Laboratory examination:

　　The auxiliary examination methods for suppurative tenosynovitis mainly include laboratory tests, which may show symptoms of infection. The examination of pus can discover purulent bacteria, and the white blood cells in the blood may increase.

　　2. Imaging examination:

　　Local ligament, bone and other tissue injuries and various degenerative changes.

　　3. Resistance test positive:

　　Due to inflammation or swelling of the tendons sheath, pain may worsen during joint hyperextension or hyperflexion, such as when the radial styloid narrow tendinous sheath or hyperflexion causes pain, and Finkelstein sign may be positive.

　　The above is the examination items for suppurative tenosynovitis, which is crucial for the diagnosis and treatment of the disease. It is necessary to actively treat suppurative tenosynovitis and prevent complications to avoid affecting the function of the affected part.

　　Purulent tenosynovitis is mostly caused by puncture wounds at the transverse creases of the palmar side of the fingers, while hemogenous infection is less common. The sheath is rich in synovial fluid, moist and less blood, providing favorable conditions for infection. Treatment requires anti-inflammatory therapy, and surgical treatment may be necessary when necessary. During the treatment period, active dietary adjustment is also very important for the recovery of the disease. The following introduces the dietary taboo for patients with purulent tenosynovitis.

　　1. The diet of patients with purulent tenosynovitis should be light, eat more vegetables and fruits, reasonably match the diet, supplement a variety of vitamins, and eat more fresh vegetables and fruits. You can eat more various lean meats, milk, eggs, etc., which are rich in protein.

　　2. Patients with purulent tenosynovitis should avoid eating foods that are too greasy and high in fat, such as fatty meat and peanuts.

　　3. Patients with purulent tenosynovitis should not eat foods such as fermented bean curd, scallions, chili peppers, chives, etc., as these foods are not conducive to wound healing because they are easy to cause infection.

　　The above is the dietary taboo for patients with purulent tenosynovitis. Scientific and reasonable diet can shorten the recovery time of patients, so dietary adjustment is very important, and attention should be paid to diet.

　　Once the diagnosis of purulent tenosynovitis is confirmed, active systemic treatment should be carried out at the same time, and local surgical treatment should be performed. Otherwise, the infection will quickly destroy the tendons, causing serious functional impairment. When the infection is in the early stage and the pus is thin, tenosynovial puncture can be used, pus and irrigation can be aspirated, and drugs can be injected after irrigation.

　　It has become obviously purulent and should be incised and drained in time. Make a lateral incision on the finger side to expose most of the sheath. Make two small windows at the near and far ends of the sheath to observe the thinness and amount of pus. If the pus is less and thin, place a plastic tube in each window, suture the wound, retain the plastic tube, and flush the sheath regularly, and inject antibiotics. Remove the plastic tube after the infection is controlled. If the pus is thick, in addition to retaining a portion of the sheath as a 'pulley', most of the sheath should be excised. If it is found that the tendons have become degenerated and necrotic, remove all the necrotic tendons and sheath, flush the wound, fill the wound with oil gauze for drainage, and change the dressing to promote wound healing.