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比较可吸收缝线与不可吸收缝线用于A1滑车松解的前瞻性随机对照试验

Prospective Randomized Controlled Trial Comparing Absorbable and Nonabsorbable Sutures in A1 Pulley Release.

作者信息

Kim Young Bae, Choi Yun Seong, Yoon Tae Hyuck, Lee Hee Dong

机构信息

Department of Orthopaedic Surgery, Veterans Health Service Medical Center, Seoul, Korea.

出版信息

Hand (N Y). 2025 Mar;20(2):203-207. doi: 10.1177/15589447231210332. Epub 2023 Nov 24.

Abstract

BACKGROUND

Both absorbable and nonabsorbable sutures are used to correct palmar incisions or lacerations. Nonabsorbable sutures have been used without complications but require removal at a follow-up appointment. Alternatively, the use of absorbable sutures has increased in popularity as postoperative suture removal is not required but is associated with local immunological and inflammatory responses. In this study, we compared the scar quality and outcomes of nonabsorbable and absorbable sutures in A1 pulley release.

METHODS

Patients who underwent A1 pulley release were randomized to 1 of 2 suture materials. The Patient Scar Assessment Scale, Observer Scar Assessment Scale, Visual Analogue Scale, and Disabilities of the Arm, Shoulder, and Hand scores were collected at 2, 6, and 12 weeks postoperatively. Among the 41 patients included in the study, 23 were randomized to the nonabsorbable suture group, and 18 to the absorbable suture group.

RESULTS

There were no significant differences between the two suture groups in the aforementioned assessments. Complication rates were higher in the nonabsorbable suture group, but the difference was not statistically significant. Notably, 1 case in the absorbable suture group had uncontrolled postoperative bleeding and required reoperation.

CONCLUSION

We found no significant difference between the two materials in terms of the Patient or Observer Scar Assessment Scales, overall complication rates, symptom scores, or pain scores. Therefore, the choice using absorbable or nonabsorbable can be guided by other factors such as physician or patient preference, availability, and cost.

摘要

背景

可吸收缝线和不可吸收缝线均用于矫正手掌切口或撕裂伤。不可吸收缝线使用过程中未出现并发症,但需要在随访预约时拆除。另外,由于术后无需拆除缝线,可吸收缝线的使用越来越普遍,但会引发局部免疫和炎症反应。在本研究中,我们比较了在A1滑车松解术中使用不可吸收缝线和可吸收缝线的瘢痕质量及效果。

方法

接受A1滑车松解术的患者被随机分为两种缝线材料组中的一组。在术后2周、6周和12周收集患者瘢痕评估量表、观察者瘢痕评估量表、视觉模拟量表以及手臂、肩部和手部功能障碍评分。在纳入研究的41例患者中,23例被随机分配至不可吸收缝线组,18例被分配至可吸收缝线组。

结果

在上述评估中,两组缝线之间没有显著差异。不可吸收缝线组的并发症发生率较高,但差异无统计学意义。值得注意的是,可吸收缝线组有1例患者术后出血无法控制,需要再次手术。

结论

我们发现,在患者或观察者瘢痕评估量表、总体并发症发生率、症状评分或疼痛评分方面,两种材料之间没有显著差异。因此,使用可吸收或不可吸收缝线的选择可由其他因素指导,如医生或患者的偏好、可用性和成本。

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