Closed continuous irrigation in the treatment of hand infections

We report our experience with a closed continuous irrigation system in 12 patients with hand infections: six cases of flexor tenosynovitis, three cases of septic arthritis and three palmar abscesses. Four of these patients had undergone previous surgical debridement and peroperative washout without elimination of the infection. The continuous irrigation system consists of two fenestrated tubes placed within the infected space, with the tip of the smaller calibre inlet tube positioned just inside the larger outlet tube. Resolution of infection was achieved in all 12 cases and all regained complete functional recovery. The closed continuous irrigation system is easy to manage, with no leakage of fluid; hand therapy may be started early and the patient is mobile throughout.