Felon: Difference between revisions
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==Background== | ==Background== | ||
*Subcutaneous pyogenic infection of the pulp space compartments of the distal finger | *Subcutaneous pyogenic infection of the pulp space compartments of the distal finger | ||
*Do not mistake for pulp erythema due to | *Do not mistake for pulp erythema due to [[Paronychia]] or [[Herpetic Whitlow]] | ||
*Infection typically begins w/ minor trauma to dermis overlying finger pad | *Infection typically begins w/ minor trauma to dermis overlying finger pad | ||
**May spread to flexor tendon sheath, IP joint, or underlying periosteum | **May spread to flexor tendon sheath, IP joint, or underlying periosteum | ||
Revision as of 21:06, 26 February 2012
Background
- Subcutaneous pyogenic infection of the pulp space compartments of the distal finger
- Do not mistake for pulp erythema due to Paronychia or Herpetic Whitlow
- Infection typically begins w/ minor trauma to dermis overlying finger pad
- May spread to flexor tendon sheath, IP joint, or underlying periosteum
Clinical Features
- Red, tense, and markedly painful distal pulp space
Diagnosis
- Gram stain and culture (chronic infections may be caused by atypical organisms)
Treatment
- Incision and drainage (see image below)
- 11 blade is used to make incision on nonoppositional side of affected digit
- Start incision 5 mm distal to flexor DIP crease
- End incision 5mm proximal to nail plate border
- Bluntly dissect and explore wound until abscess is decompressed
- Pack w/ sterile gauze
- Instruct pt to keep extremity elevated
- Abx indicated for felons associated w/ cellulitis
Source
- Tintinalli