Sunjic Roguljic Veridijana, Roguljic Luka, Kovacic Vedran, Bilic Ivica, Jukic Ivana
Department of Surgery, Division of Plastic, Reconstructive and Aesthetic Surgery With Burn Care, University Hospital of Split, Split, HRV.
Department of Surgery, Division of Orthopaedics and Traumatology, University Hospital of Split, Split, HRV.
Cureus. 2024 Jan 31;16(1):e53312. doi: 10.7759/cureus.53312. eCollection 2024 Jan.
Background Carpal tunnel syndrome (CTS) is caused by compression of the median nerve in the carpal tunnel. The effect of tissue adhesives as a material for wound closure following CTS decompression has been insufficiently investigated. This study aimed to evaluate outcomes by comparing two modalities of wound closure following carpal surgery in patients randomly assigned to either tissue adhesives or sutures. Methodology This randomized, prospective study was conducted in April 2022 at the University Hospital of Split in Croatia. Patients aged 61.56 ± 12.03 years were randomized to either tissue adhesive Glubran Tiss 2®-based (n = 50) or suture-based (n = 50) wound-closure techniques. The following outcomes were assessed before surgery and six months postoperatively: hand strength, electroneurographic characteristics of the median nerve, and the Boston Carpal Tunnel Questionnaire. Results Significant differences between glue-based and suture-based wound-closure techniques were found in the six-month postoperative hand grip strength (25.06 ± 6.69 vs. 21.41 ± 5.62 kg; p = 0.002), postoperative sensory amplitude (10.08 ± 5.50 vs. 7.54 ± 5.41 mV; p = 0.012), and postoperative sensory velocity (42.22 ± 11.04 vs. 35.23 ± 16.40 m/s; p = 0.008). In the glue-based group, significantly more patients achieved a postoperative sensory velocity greater than 45 m/s (47.9% vs. 22.0%; p= 0.006), postoperative distal sensory latency less than 3.5 ms (89.6% vs. 84.0%; p = 0.304), and postoperative motor latency of less than 4.2 ms (60.42% vs. 38.00%; p = 0.022). Conclusions This trial demonstrated that cyanoacrylate-based adhesion material for wound closure after open CTS decompression compared with sutures showed a significant six-month postoperative increment in hand grip strength and median nerve sensory conduction.
背景 腕管综合征（CTS）是由腕管内正中神经受压引起的。组织粘合剂作为CTS减压术后伤口闭合材料的效果尚未得到充分研究。本研究旨在通过比较随机分配接受组织粘合剂或缝线治疗的腕管手术后两种伤口闭合方式的结果来进行评估。方法 这项随机、前瞻性研究于2022年4月在克罗地亚斯普利特大学医院进行。年龄为61.56±12.03岁的患者被随机分为基于组织粘合剂Glubran Tiss 2®的伤口闭合技术组（n = 50）或基于缝线的伤口闭合技术组（n = 50）。在手术前和术后六个月评估以下结果：手部力量、正中神经的神经电生理特征以及波士顿腕管问卷。结果 基于胶水和基于缝线的伤口闭合技术在术后六个月的手握力（25.06±6.69 vs. 21.41±5.62 kg；p = 0.002）、术后感觉振幅（10.08±5.50 vs. 7.54±5.41 mV；p = 0.012）和术后感觉速度（42.22±11.04 vs. 35.23±16.40 m/s；p = 0.008）方面存在显著差异。在基于胶水的组中，显著更多的患者术后感觉速度大于45 m/s（47.9% vs. 22.0%；p = 0.006），术后远端感觉潜伏期小于3.5 ms（89.6% vs. 84.0%；p = 0.304），以及术后运动潜伏期小于4.2 ms（60.42% vs. 38.00%；p = 0.022）。结论 本试验表明，与缝线相比，用于开放性CTS减压术后伤口闭合的氰基丙烯酸酯基粘合材料在术后六个月时手握力和正中神经感觉传导有显著增加。
