Including a Vessel Loop in Wound Closure Facilitates Suture Removal Following Open Carpal Tunnel Release.

BACKGROUND

Many hand surgeons prefer to close palmar wounds with non-absorbable mattress sutures. Suture removal can be painful and time-consuming. In this study, we investigated if suture removal can be facilitated by including a vessel loop in wound closure following open carpal tunnel release (CTR).

METHODS

Overall, 47 patients aged 18 to 75 undergoing elective primary open unilateral CTR completed this unblinded, prospective randomized controlled superiority trial. Subjects were randomized into 1 of 2 study arms: (1) wound closure without a vessel loop (standard, n = 28); or (2) wound closure with a vessel loop (vessel loop, n = 19). Data were collected on time for wound closure and for suture removal. A visual analog scale (VAS) was used to assess satisfaction and pain with suture removal.

RESULTS

There were no significant differences between the 2 groups in patient demographics or time for suture placement. Visual analog scale satisfaction with suture removal was significantly lower in the standard group (8.6 ± 2.6) compared to vessel loop group (9.9 ± 0.28, < .05). VAS pain with suture removal was significantly higher in the standard group (2.6 ± 2.7) versus vessel loop group (0.68 ± 1.1, < .01). Additionally, suture removal time was significantly longer in standard group (84 seconds ± 83) versus vessel loop group (31 seconds ± 13, < .0001).

CONCLUSIONS

Addition of a vessel loop in wound closure for primary open CTR increases patient satisfaction and reduces pain with and time taken for suture removal.