The treatment of felons and paronychias

Infections of the distal finger have a varied presentation, course, and treatment. As in other hand infections, initial treatment should always include elevation of the extremity and the avoidance of snug clothing or constricting jewelry. Immunosuppressive states and systemic diseases such as diabetes must be considered, for they will alter the action of the causative organisms as well as the intensity of treatment that a patient will require. Appropriate, specific antibiotic treatment can be part of the initial treatment of acute felons and paronychias, but it should never replace adequate incision and drainage. Finally, "minor" finger infections are only minor when diagnosed and treated properly. If mistreated, their consequences can have long-term implications for both the individual and for society. It is important to understand the natural history, bacteriology, and anatomy of the distal finger if we are to return patients to their jobs with expedience and minimal long-term sequelae.

Hand complications in children from digital sucking

Digital sucking is common in children. Although orthodontic complications have been reported, hand complications of digital sucking are seldom described. Five patients are reported; two had digital deformities and three had infections. Deformities of the digits were improved with splinting. Infections required surgical drainage followed by postoperative splint protection to prevent digital sucking. Splinting prohibited sucking in four of five patients.

[Treatment of complicated forms of paronychia by using the electrophoresis of anti-inflammatory and antimicrobial preparations]

The work presents an analysis of treatment of patients with complicated forms of panaritium. To increase the efficiency of treatment the authors used certain physical factors, in particular, direct electric current--interstitial (intracavitary) electrophoresis of antimicrobial and antiinflammatory agents in complex therapy. The investigation of results of the treatment shows sufficiently high efficiency of the interstitial (intracavitary) electrophoresis. The time of treatment of patients with complicated forms of panaritium became 2 times shorter.

[Diagnosis and treatment of bone paronychia]

Examination and operations were made on 46 patients with bony panaritium. Early diagnosis of this disease along with X-ray examination were based on data of case histories of the patients and clinical symptoms. Surgical treatment included parsimonious dissection of necrotic tissues and suturing the wounds. In cases of large subcutaneous cavities drainage of the wound by perfusion with an antiseptic solution was used. Best results were obtained with the help of tamponage of the wound following removal of the altered tissues by a dry gauze turunda and a bath with the solution of potassium permanganate of feziamon.

[Operative treatment of osseous and osteoarticular paronychia by applying a closed suture to the wound and by prolonged intra-osseous administration of antibiotics]

Continuous intraosseous injections of antibiotics were used in 104 patients in the operative treatment of bony and osteo-articular panaritium with putting primary sutures on the wound. Healing by first intention was noted in most cases.

[Blind suture for paronychia in children]

From 1966 the author has been using the method of early surgical treatment of complicated forms of panaritium in order to remove the pyo-necrotic substrate and place primary sutures on the wound. The age of ninety children was from 1 year 8 month to 15. The primary suture provides better anatomical and functional results of treatment of panaritium in children and shortens the time of treatment.