MacFarlane Robert J, Donnelly Thomas D, Khan Yousaf, Morapudi Syam, Waseem Mohammad, Fischer Jochen
Department of Trauma and Orthopaedics, Macclesfield District General Hospital, East Cheshire NHS Trust, Victoria Road, Macclesfield SK10 3BL, UK.
Biomed Res Int. 2014;2014:270137. doi: 10.1155/2014/270137. Epub 2014 Aug 7.
Debate exists amongst surgeons regarding the ideal suture material for skin closure in carpal tunnel decompression (CTD). This study compares wound related complications, patient satisfaction, and functional outcome following open carpal tunnel decompression in patients undergoing wound closure with either of two common absorbable and nonabsorbable suture types.
53 patients underwent CTD with either 4/0 polypropylene (ProleneTM, n = 28) or 4/0 polyglactin (Vicryl RapideTM, n = 25) for skin closure. QuickDASH, VAS satisfaction scores, and Southampton wound scores were assessed preoperatively and at 2 and 6 weeks postoperatively.
At 6 weeks the mean QuickDASH scores postoperatively were 18.54 and 17.70 for absorbable and nonabsorbable sutures, respectively, (P = 0.86). The mean VAS scores were 0.61 and 0.42 (P = 0.91), respectively. All patients achieved a Southampton wound score of 0 by 6 weeks except one, who achieved 1C in the nonabsorbable group, equivalent to mild erythema. There were no complications in either group.
Both suture types are safe and effective materials for CTD, and we recommend surgeons to choose according to personal preference, handling properties, and resources available for suture removal.
在腕管减压术（CTD）中，外科医生对于皮肤缝合的理想缝合材料存在争议。本研究比较了采用两种常见的可吸收和不可吸收缝合线之一进行伤口缝合的腕管减压术患者的伤口相关并发症、患者满意度和功能结果。
53例患者接受了CTD手术，其中28例使用4/0聚丙烯（普理灵TM），25例使用4/0聚乙交酯丙交酯共聚物（快薇乔TM）进行皮肤缝合。术前以及术后2周和6周评估QuickDASH、视觉模拟评分（VAS）满意度得分和南安普敦伤口评分。
6周时，可吸收缝线和不可吸收缝线术后的平均QuickDASH得分分别为18.54和17.70（P = 0.86）。平均VAS得分分别为0.61和0.42（P = 0.91）。除1例在不可吸收缝线组达到1C（相当于轻度红斑）外，所有患者在6周时南安普敦伤口评分为0。两组均无并发症发生。
两种缝合线都是用于CTD的安全有效的材料，我们建议外科医生根据个人偏好、操作特性和可用于拆线的资源来选择。
