Flexor Sheath Infections, Antibiotic Treatment (1272)

A guideline is intended to assist healthcare professionals in the choice of disease-specific treatments.

Clinical judgement should be exercised on the applicability of any guideline, influenced by individual patient characteristics. Clinicians should be mindful of the potential for harmful polypharmacy and increased susceptibility to adverse drug reactions in patients with multiple morbidities or frailty.

If, after discussion with the patient or carer, there are good reasons for not following a guideline, it is good practice to record these and communicate them to others involved in the care of the patient.

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Editorial Information

Last reviewed: 20/03/2026

Next review date: 28/02/2029

Author(s): Pauline Wright, Harriet Eastwood, Alexander Curran.

Version: 1

Author email(s): Pauline.Wright4@nhs.scot.

Approved By: Antimicrobial Utilisation Committee

Document Id: 1272

References
  1. Flexor Sheath Infection  [Internet]. British Society for Surgery of the Hand ; [cited 2023 Nov 10]. Available from: Flexor Sheath Infection https://www.bssh.ac.uk/_userfiles/pages/files/professionals/Trauma%20standards/10%20Flexor%20sheath%20infection.pdf
  2. Pyogenic flexor tenosynovitis [Internet]. [cited 2023 Nov 10]. Available from: https://www.orthobullets.com/hand/6105/pyogenic-flexor-tenosynovitis
  3. Kennedy CD, Huang JI, Hanel DP. In brief: Kanavel’s signs and pyogenic flexor tenosynovitis. Clinical Orthopaedics & Related Research. 2016;474(1):280–4. doi:10.1007/s11999-015-4367-x
  4. Leppänen OV, Jokihaara J, Kaivorinne A, Havulinna J, Göransson H. Protocol for an investigator-blinded, randomised, 3-month, parallel-group study to compare the efficacy of intraoperative tendon sheath irrigation only with both intraoperative and postoperative irrigation in the treatment of purulent flexor tenosynovitis. BMJ Open. 2015;5(12). doi:10.1136/bmjopen-2015-008824
  5. Bruner JM. The zig-zag volar-digital incision for Flexor-tendon surgery. Plastic and Reconstructive Surgery. 1967;40(6):571–4. doi:10.1097/00006534-196740060-00010