Looped Penrose Drainages of Acute Hand Infections in Vulnerable Populations

Area of Science:

• Orthopedics
• Hand Surgery
• Infectious Diseases

Background:

• Acute hand infections (AHIs) present challenges for hand surgeons, with outcomes often impacted by social barriers.
• Socioeconomically vulnerable populations, particularly in urban settings, face unique difficulties in managing AHIs.
• The looped Penrose drainage technique was previously developed to simplify AHI management and reduce follow-up burdens.

Purpose of the Study:

• To evaluate the clinical features and outcomes of the looped Penrose drainage technique in an urban patient population with AHIs.
• To assess the efficacy of this less invasive technique in managing complex social challenges associated with AHI.
• To characterize the applicability of the looped Penrose technique in a diverse urban patient cohort.

Main Methods:

• A retrospective review of surgical irrigations for AHIs performed by a single hand surgeon at an urban hospital between 2013 and 2021.
• Analysis of patient demographics, procedural details, and post-procedure outcomes for 53 patients.
• Inclusion of data on insurance status, employment, income, and homelessness to assess social factors.

Main Results:

• Fifty-three patients with AHIs were treated using the looped Penrose drainage technique.
• The patient cohort included a high proportion of individuals with socioeconomic vulnerabilities (e.g., public insurance, unemployment, low income, homelessness).
• The technique demonstrated low rates of complications, with only one reoperation (1.9%) and no amputations or readmissions. Postoperative emergency department visits were managed successfully.

Conclusions:

• The looped Penrose technique is a simple, effective, and less invasive alternative for treating AHIs.
• It is particularly beneficial for patients with complex social challenges, simplifying wound management.
• The technique serves as an effective single-episode intervention with low rates of readmission and reoperation.