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腕管切开术后尼龙间断缝合与皮下连续快薇乔缝合手术伤口闭合的比较研究

Comparative study of surgical wound closure with nylon interrupted sutures and running subcuticular vicryl rapide suture after open release of the carpal tunnel.

作者信息

Tzimas Vasileios, Kotsias Christos, Galanis Charilaos, Panagiotakopoulos Georgios, Tsiampas Dimitrios, Parnis Juanita, Tilkeridis Konstantinos, Fiska Aliki

机构信息

Trauma and Orthopedics Department, General Hospital of Ioannina, Ioannina, Greece.

Trauma and Orthopedics Department, General Hospital of Filiates, Ioannina, Greece.

出版信息

Scars Burn Heal. 2022 Sep 29;8:20595131221128951. doi: 10.1177/20595131221128951. eCollection 2022 Jan-Dec.

Abstract

BACKGROUND

Surgical decompression of the carpal tunnel is considered the method of choice for its treatment with satisfactory results documented. Various methods and suturing materials have been used for closure of the surgical wound. In the present study, we compared interrupted mattress closure by means of nylon suture to running subcuticular closure with vicryl rapide suture. As far as we know, there is no similar study in the literature.

METHODS

A total of twenty patients were included in the study. Ten of them had their surgical wound closed with 3.0 nylon suture in an interrupted fashion and for the rest, a running subcuticular 3.0 vicryl rapide was used. All patients filled in a questionnaire about VAS perceived pain and a Quick DASH score sheet, preoperatively, at two and six weeks postoperatively. The cosmesis of the scar was assessed using the POSAS v2.0 system at two and six weeks after surgery and overall incidence of infections was noted as well.

RESULTS

There was no statistically important difference between the two groups of patients in regards to postoperative VAS pain levels at two and six weeks. Likewise, no statistically significant difference was evident as far as Quick DASH score, POSAS score and infections were concerned.

CONCLUSIONS

Our results suggest that the use of running subcuticular vicryl rapide suture is an attractive alternative to interrupted nylon sutures for closure after open carpal tunnel decompression, lacking any significant drawbacks.

LAY SUMMARY

Surgery for carpal tunnel decompression is considered the method of choice for its treatment with documented satisfactory results. Various methods and suturing materials have been used for closure of the surgical wound. In the present study, we compared the use of a non-absorbable suture, placed intermittently to an absorbable continuous intradermal suture. A total of twenty patients were included in the study. Half of them had their wound closed with the absorbable suture and the other half with the non-absorbable suture, as described above. All patients were evaluated as far as pain, scar characteristics, functional outcomes of the operated hand and incidence of infection, at two and six weeks after surgery. After analysis of the data, no significant differences were found between the two groups, suggesting that both of these techniques are equally safe and efficacious.

摘要

背景

腕管减压术被认为是治疗腕管综合征的首选方法,且已有文献记载其效果令人满意。手术切口的闭合采用了多种方法和缝合材料。在本研究中,我们比较了用尼龙缝线间断褥式缝合与用快薇乔缝线连续皮下缝合的效果。据我们所知,文献中尚无类似研究。

方法

本研究共纳入20例患者。其中10例患者的手术切口用3.0尼龙缝线间断缝合,其余患者则使用3.0快薇乔缝线连续皮下缝合。所有患者在术前、术后两周和六周时填写一份关于视觉模拟评分法(VAS)疼痛感受的问卷以及一份快速残疾上肢评定量表(Quick DASH)评分表。术后两周和六周时,使用患者和观察者瘢痕评估量表(POSAS v2.0系统)评估瘢痕的美观程度,并记录感染的总体发生率。

结果

两组患者在术后两周和六周时的VAS疼痛水平无统计学显著差异。同样,在Quick DASH评分、POSAS评分和感染方面也没有明显的统计学显著差异。

结论

我们的结果表明,对于开放性腕管减压术后的切口闭合,使用快薇乔缝线连续皮下缝合是一种优于尼龙缝线间断缝合的有吸引力的选择,且没有任何明显缺点。

简要概述

腕管减压手术被认为是治疗腕管综合征的首选方法,且已有文献记载其效果令人满意。手术切口的闭合采用了多种方法和缝合材料。在本研究中,我们比较了不可吸收缝线间断缝合与可吸收连续皮内缝合的使用情况。本研究共纳入20例患者。如上所述,其中一半患者的伤口用可吸收缝线缝合,另一半患者的伤口用不可吸收缝线缝合。所有患者在术后两周和六周时,就疼痛、瘢痕特征、手术手的功能结果和感染发生率进行了评估。数据分析后发现两组之间无显著差异,这表明这两种技术同样安全有效。

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