Nemirov Daniel, Dentcheva Eva, Thurmond Taylor, Bachoura Abdo, Hirsch David, Tosti Rick
Rothman Orthopaedic Institute, 925 Chestnut Street, Philadelphia, PA, 19107, USA.
Thomas Jefferson University Hospital, 111 S 11th St., Philadelphia, PA, 19107, USA.
J Hand Microsurg. 2024 Nov 19;17(1):100178. doi: 10.1016/j.jham.2024.100178. eCollection 2025 Jan.
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.
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.
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.
Wound closure in hand surgery using absorbable suture appears to have comparable outcomes with non-absorbable suture.
在择期手部手术缝合中，传统上一直选用不可吸收缝线（NAS）而非可吸收缝线（AS）。本研究的目的是评估各种原发性择期手部手术中可吸收缝线与不可吸收缝线缝合的效果。我们的研究小组假设在主要短期结果方面不存在差异。
对867例患者进行回顾性研究。使用特定于从前臂到指尖手术病例的现行手术操作术语（CPT）编码来识别患者。排除接受急诊创伤手术或因感染进行清创的患者。评估两个实验组：一组采用不可吸收缝线（尼龙）进行手术伤口缝合，另一组采用可吸收缝线（聚乙醇酸缝线）进行缝合。测量的结果包括伤口裂开、术后抗生素使用需求、30天内的一般并发症以及60天内的再次手术情况。
本研究共调查了867例患者。可吸收缝线组有455例患者，不可吸收缝线组有412例。在年龄、性别或糖尿病方面，可吸收缝线组与不可吸收缝线组之间未发现显著差异。术后，在伤口裂开、感染或抗生素处方率方面没有显著差异。此外，可吸收缝线组与不可吸收缝线组之间的30天并发症发生率（1.36%对1.47%；p = 1.000）、60天并发症发生率（0.68%对2.19%；p = 0.113）和再次手术率（1.13%对1.46%；p = 0.903）相似。
在手部手术中使用可吸收缝线进行伤口缝合似乎与使用不可吸收缝线具有相当的效果。
3级。
