Felon: Difference between revisions

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==Treatment==
==Treatment==
*Incision and drainage (see image below)
===Incision and drainage===
**Number 11 blade is used to make incision on nonoppositional side of affected digit
(see image below)
***Start incision 5 mm distal to flexor DIP crease
*Number 11 blade is used to make incision on nonoppositional side of affected digit
***End incision 5mm proximal to nail plate border
*Start incision 5 mm distal to flexor DIP crease
**Bluntly dissect and explore wound until abscess is decompressed
*End incision 5mm proximal to nail plate border
**Pack w/ sterile gauze
*Bluntly dissect and explore wound until abscess is decompressed
*Instruct pt to keep extremity elevated
''no need for packing''
*Abx indicated for felons associated w/ cellulitis
 
*Dispo f/u in 2 days for wound check
**ortho only if complications
[[File:Felon.jpg]]
[[File:Felon.jpg]]



Revision as of 19:56, 16 November 2014

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)

Differential Diagnosis

Hand and finger infections

Look-Alikes

Treatment

Incision and drainage

(see image below)

  • Number 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

no need for packing

Felon.jpg

See Also

Hand Infection

Source

  • Clark, DC. Common Acute Hand Infections. Am Fam Physician 2003;68:2167-76