TY - CHAP M1 - Book, Section TI - Suture of Tendon A1 - Ellison, E. Christopher A1 - Zollinger, Jr., Robert M. A1 - Pawlik, Timothy M. A1 - Vaccaro, Patrick S. A1 - Bitans, Marita A1 - Baker, Anthony S. PY - 2022 T2 - Zollinger’s Atlas of Surgical Operations, 11e AB - Repair of the lacerated flexor tendon should only be performed under ideal conditions because the best (and sometimes only) opportunity for a good functional result is the first attempt at repair. The presence of severe contamination, infection, or massive tissue destruction should be a contraindication for immediate repair. Debridement and wound preparation should be performed emergently, but definitive repair may be performed safely at a later time (ideally less than a week from injury). Extensor tendon repair is relatively more straightforward. Extensor tendons bear less force, and delayed repair is more forgiving. Flexor tendon repair is more demanding, particularly where the tendon excursion occurs within the confines of a tunnel of tendon sheath and a series of pulleys. In addition, because of proximity, flexor tendon injuries of the hands are typically associated with arterial and nerve lacerations. Ideally, artery and nerve repair should precede tendon repair. In cases where access to microscopic capabilities is limited and there is no clinically apparent vascular embarrassment of the digit distal to the injury, then there is no mandate for repair of arterial injury. Sensory nerve repair can be delayed if recognition is delayed (with recognition that repair of the nerve is most easily accomplished prior to attempted flexor tendon repair). SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesssurgery.mhmedical.com/content.aspx?aid=1187824861 ER -