A retrospective comparison of absorbable versus non-absorbable sutures for elective hand surgery wound closures.

BACKGROUND

Suture selection in elective hand surgery closures has traditionally been non-absorbable sutures (NAS) rather than absorbable sutures (AS). The goal of this study was to evaluate absorbable versus non-absorbable closures of various primary elective hand procedures. Our group hypothesized that no differences in major short-term outcomes would exist.

METHODS

A retrospective review of 867 patients was conducted. Patients were identified using Current Procedural Terminology (CPT) codes specific to surgical cases from forearm to fingertip. Patients undergoing emergent trauma operations or debridement for infection were excluded. Two experimental groups were evaluated: one in which surgical wound closures were performed with non-absorbable suture (nylon) vs one in which closures were performed with absorbable suture (monocryl). Outcomes measured were wound dehiscence, need for postoperative antibiotics, 30-day general complications, and reoperations within 60 days.

RESULTS

A total of 867 patients were investigated in this study. The AS cohort consisted of 455 patients whereas the NAS group contained 412. No significant differences were noted between the AS and NAS groups with regards to age, gender, or diabetes. Postoperatively, there was no significant difference in rates of dehiscence, infections, or antibiotic prescription. Furthermore, rates of 30-day complications (1.36 % vs 1.47 %; p = 1.000), 60-day complications (0.68 % vs 2.19 %; p = 0.113) and reoperation (1.13 % versus 1.46 %; p = 0.903) were similar between the AS and NAS cohorts.

CONCLUSION

Wound closure in hand surgery using absorbable suture appears to have comparable outcomes with non-absorbable suture.

LEVEL OF EVIDENCE