Name of the Procedure:

Drainage of Tendon Sheath, Digit and/or Palm (Synovial Sheath Drainage)

Summary

In this procedure, a healthcare provider drains excess fluid or pus from the sheath surrounding a tendon in a finger or palm to relieve pain and prevent infection.

Purpose

The procedure is aimed at treating infections or inflammations of the tendon sheath, typically due to conditions like tenosynovitis or an abscess, to reduce pain, swelling, and improve tendon function.

Indications

• Severe pain and swelling in a finger or palm
• Difficulty moving the affected digit
• Presence of pus or infection in the tendon sheath
• Positive signs of infection, such as redness, warmth, or fever

Preparation

• Fasting may be required if general anesthesia is planned.
• Pre-procedure blood tests may be necessary to check for infection markers.
• Review of current medications; some may need to be adjusted or paused.

Procedure Description

1. The affected area is cleaned and prepped with antiseptic solution.
2. Local or general anesthesia is administered.
3. A small incision is made to expose the tendon sheath.
4. A drainage tube or needle is used to remove excess fluid or pus.
5. The area is irrigated and cleaned thoroughly.
6. The incision is closed with sutures and a sterile dressing is applied.

Tools & Equipment:

• Scalpels, drainage tubes, irrigating solutions.
• Sterile dressings, sutures, and antiseptic agents.

Duration

The procedure typically takes between 30 minutes to 1 hour.

Setting

This procedure can be performed in an outpatient clinic, surgical center, or hospital operating room.

Personnel

• Hand surgeon or orthopedic surgeon
• Surgical nurse or assistant
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Infection at the incision site
• Damage to surrounding tissues or nerves
• Scarring or reduced mobility in the affected digit
• Anesthetic complications
• Recurrence of infection or fluid accumulation

Benefits

• Rapid relief from pain and swelling
• Prevention of further infection spread
• Improved mobility and function of the affected digit
• Quick return to normal activities

Recovery

• Keep the affected hand elevated to reduce swelling.
• Follow wound care instructions, including keeping the area clean and dry.
• Take prescribed antibiotics or pain medication as directed.
• Avoid strenuous activities with the affected hand for several weeks.
• Attend follow-up appointments for monitoring and suture removal.

Alternatives

• Antibiotic therapy alone (may not be effective if an abscess is present).
• Aspiration (fluid removal by needle, less invasive but may not be comprehensive).
• Oral anti-inflammatory medications (may offer temporary relief).

Patient Experience

• Mild to moderate discomfort during and after the procedure, managed with anesthetics and pain relievers.
• Some soreness and limited movement in the affected digit for a few days.
• Post-operative swelling and need for diligent wound care to prevent infection.