Perioperative management - Flexor tendon suture according to Kirchmayr-Kessler

• Transection of both flexor tendons with loss of flexion
• Transection of the deep flexor tendon (FDP) with preserved superficial flexor tendon (FDS) in manually active patients

• Local or general conditions that surgically or anesthesiologically contraindicate an elective operation or that can be improved preoperatively

• Clinical examination:
  → Loss of active flexion of the middle and/or distal joint of the finger

• no special preparation of the patient necessary
• generally outpatient procedure
• Assessment of contraindications for bloodless field (e.g., existing shunt in dialysis)

Information on

• surgical method
• extension procedures such as e.g. reconstruction of artery, nerve, flexor tendon sheath; change of procedure to replacement plastic or tendon transplant

• general surgical risks
  • wound healing disorder
  • tendon injury
  • functional deficit wrist/hand
  • CRPS = Sudeck's disease

• specific surgical risks
  • postoperative scarring
  • flexor tendon sheath infection
  • secondary tendon ruptures due to failure of the primary suture