Looped Penrose Drainages of Acute Hand Infections in Vulnerable Populations.

J Hand Surg Am

Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia; Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA. Electronic address:

Published: January 2025

Purpose: Acute hand infections (AHIs) remain a challenge for hand surgeons and represent a condition for which clinical outcomes are considerably affected by social barriers. We previously described the looped Penrose drainage technique, where a drain is sutured to itself in a loop and the outflow tract of egress is maintained, thus obviating the need for large incisions, wound closure, or repeat packing, thereby reducing the follow-up burden. In the face of escalating numbers of socioeconomically vulnerable patients, especially in urban settings, we aimed to characterize the clinical features and outcomes of this technique in an urban population of patients with AHI.

Methods: A review of all surgical irrigations of AHI by a single, fellowship-trained hand surgeon at an urban hospital from 2013 through 2021 was performed. Patient demographics, procedure details, and postprocedure outcomes were analyzed.

Results: Fifty-three patients (average age, 48.6 years) with AHI underwent surgical irrigations with the looped Penrose drainage technique. The majority of patients were Black (50.9%). Approximately 81.1% of the patients received public insurance, 22.6% were unemployed, 35.9% had annual incomes <$40,000, and 17% experienced homelessness. Overall, 34% were lost to follow-up with the Penrose still intact, including 78% of those who were homeless. Most of the cases occurred on the hand, with involvement of the deep spaces (24.5%), tenosynovitis (39.3%), and bone (1.9%). Recurrent infection (1.9%) and abscess formation (5.7%) led to one reoperation (1.9%). There were no amputations or readmissions, and all postoperative emergency department visits (7.1%) were discharged.

Conclusions: The looped Penrose technique is a simple and less invasive alternative to traditional incision and drainage with packing and serves as an effective single-episode intervention strategy for AHIs, particularly in patients with complex social challenges because of the ease of wound management and low rates of readmission and reoperation.

Type Of Study/level Of Evidence: Therapeutic IV.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jhsa.2024.11.015DOI Listing

Publication Analysis

Top Keywords

looped penrose
12
acute hand
8
hand infections
8
penrose drainage
8
drainage technique
8
surgical irrigations
8
patients
5
penrose drainages
4
drainages acute
4
hand
4

Similar Publications

Looped Penrose Drainages of Acute Hand Infections in Vulnerable Populations.

J Hand Surg Am

January 2025

Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia; Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA. Electronic address:

Purpose: Acute hand infections (AHIs) remain a challenge for hand surgeons and represent a condition for which clinical outcomes are considerably affected by social barriers. We previously described the looped Penrose drainage technique, where a drain is sutured to itself in a loop and the outflow tract of egress is maintained, thus obviating the need for large incisions, wound closure, or repeat packing, thereby reducing the follow-up burden. In the face of escalating numbers of socioeconomically vulnerable patients, especially in urban settings, we aimed to characterize the clinical features and outcomes of this technique in an urban population of patients with AHI.

View Article and Find Full Text PDF

Spin dynamics, loop formation and cooperative reversal in artificial quasicrystals with tailored exchange coupling.

Commun Phys

July 2023

Laboratory of Nanoscale Magnetic Materials and Magnonics, Institute of Materials (IMX), École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland.

Aperiodicity and un-conventional rotational symmetries allow quasicrystalline structures to exhibit unusual physical and functional properties. In magnetism, artificial ferromagnetic quasicrystals exhibited knee anomalies suggesting reprogrammable magnetic properties via non-stochastic switching. However, the decisive roles of short-range exchange and long-range dipolar interactions have not yet been clarified for optimized reconfigurable functionality.

View Article and Find Full Text PDF

The abscess is a common complication of Crohn's disease (CD), with the perianal form more frequent than gluteal or presacral which is relatively rare. There are few case reports of gluteal abscess combined with presacral abscess caused by CD and the treatment has not been established. A 21-year-old male was admitted with right buttock and lower back pain with a duration of 3 months.

View Article and Find Full Text PDF

Purpose: In adult rats, intravitreal injections of the Rho-GTPase inhibitor C3 transferase (BA-210), or a cocktail of recombinant ciliary neurotrophic factor (CNTF) and a cyclic AMP analogue (CPTcAMP), increase retinal ganglion cell (RGC) survival and axonal regeneration. Here we examined whether these treatments also affect the dendritic architecture of regrowing RGCs.

Methods: In Fischer F344 rats, one optic nerve was cut and an autologous peripheral nerve graft was sutured onto it.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!