Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, 15 Karnjanavanich Road, Hat Yai, Songkhla, 90110, Thailand.
J Orthop Surg Res. 2021 Sep 17;16(1):565. doi: 10.1186/s13018-021-02710-0.
There are various skin suture techniques for wound closure following carpal tunnel release, and well-performed suturing will result in low post-operative scar tenderness. The aim of this study was to compare the Donati suture technique and running subcuticular technique in terms of surgical scar, post-operative pain and functional outcome in open carpal tunnel release.
One-hundred forty-two patients were randomized using a computer-generated random number table into two groups receiving either running subcuticular suturing or Donati suturing after surgical intervention. We evaluated postoperative scarring using the Patient and Observer Scar Assessment Scale (POSAS), pain intensity using a verbal numerical rating scale, and functional outcomes using the Thai version of the Boston Carpal Tunnel Questionnaire after surgical decompression for carpal tunnel syndrome at 2, 6, and 12 weeks. Continuous data are reported as mean ± SD while normally distributed or as median (interquartile range) when the distribution was skewed.
Lower scores at 2 weeks were given by the patients receiving the running subcuticular suture technique than the Donati suture technique (15.3 ± 4.8 vs 17 ± 4.6, respectively, P < 0.05) while the observer scores were not significantly different (15.6 ± 5.8 vs 16.7 ± 5.2, respectively, P = 0.15). At both 6 and 12 weeks post-surgical decompression both patient and observer scores were not significantly different. There were no differences between the groups in terms of VNRS pain scores and functional Boston Carpal Tunnel Scores at all time points.
This randomized controlled trial found that although scarring assessments were slightly better in the earliest period following wound closure after surgical decompression in carpal tunnel syndrome using the running subcuticular suture, the final results at 3 months postoperative were not significantly different.
The study was registered at https://www.thaiclinicaltrials.org/ (TCTR20191204002).
腕管松解术后有多种皮肤缝合技术，良好的缝合技术可降低术后疤痕的触痛。本研究旨在比较 Donati 缝合技术和连续皮下缝合技术在开放式腕管松解术后手术疤痕、术后疼痛和功能结果方面的差异。
采用计算机生成的随机数表将 142 例患者随机分为两组，分别采用连续皮下缝合或 Donati 缝合。我们使用患者和观察者疤痕评估量表（POSAS）评估术后疤痕，使用数字评分量表（VNRS）评估疼痛强度，使用泰国版波士顿腕管问卷（BCTQ）评估术后功能结果，分别在术后 2、6、12 周进行评估。连续数据以均数±标准差表示，正态分布时；偏态分布时以中位数（四分位间距）表示。
接受连续皮下缝合技术的患者在术后 2 周时的评分低于接受 Donati 缝合技术的患者（分别为 15.3±4.8 与 17±4.6，P＜0.05），但观察者评分无显著差异（分别为 15.6±5.8 与 16.7±5.2，P=0.15）。术后 6 周和 12 周时，患者和观察者评分均无显著差异。两组在 VNRS 疼痛评分和功能波士顿腕管评分方面在所有时间点均无差异。
本随机对照试验发现，与连续皮下缝合相比，Donati 缝合在腕管松解术后早期伤口闭合时的疤痕评估略好，但术后 3 个月的最终结果并无显著差异。
本研究在泰国临床试验注册中心注册（TCTR20191204002）。
