Leary Jessica, Frampton Chris, Muller Andrew, Lynskey Timothy
Department of Orthopaedic Surgery, Taranaki Base Hospital, New Plymouth, New Zealand.
University of Otago Christchurch, Christchurch Central, New Zealand.
ANZ J Surg. 2025 Mar;95(3):527-532. doi: 10.1111/ans.70030. Epub 2025 Mar 4.
This randomized controlled trial (RCT) compared outcomes of absorbable and non-absorbable sutures for skin closure in open carpal tunnel decompression.
Patients diagnosed with bilateral carpal tunnel syndrome proceeding to staged open carpal decompression were invited to participate in the trial. Patients elected left or right hand for the first operation and were randomized to receive Prolene (non-absorbable) or Vicryl Rapide (absorbable) first, and the alternative suture to the contralateral side. Recorded pre-operative data included the Boston Carpal Tunnel Questionnaire (BCTQ) for each hand. At 2 weeks post-operatively the BCTQ, a Visual Analogue Score (VAS) for pain and Asepsis Wound Score were recorded. At 6 weeks, the BCTQ and VAS were repeated and a Patient and Observer Scar Assessment Scale (POSAS) was performed. Patients were asked preference for left or right suture. Statistical analysis using a linear mixed model assessed improvements in the BCTQ, as well as wound scores between sutures. The individual scales were compared using non-parametric Wilcoxon signed rank test. Specific patient factors including age, comorbidities, and previous steroid injections were evaluated for their impact on outcome.
There was no significant difference between the two suture types in any of the overall recorded assessments, complications or patient preferences. BCTQ scores improved significantly post-operatively, P = 0.001. Previous steroid injection, diabetes and age over 65 did not affect outcomes.
Patients can be advised there is no difference in the outcome following open carpal tunnel decompression from using either absorbable or no-absorbable suture material for skin closure.
本随机对照试验（RCT）比较了开放式腕管减压术中可吸收缝线与不可吸收缝线用于皮肤缝合的效果。
邀请被诊断为双侧腕管综合征并计划进行分期开放式腕管减压术的患者参与试验。患者选择左手或右手进行首次手术，并随机分为先接受普理灵（不可吸收）或薇乔快吸收缝线（可吸收），对侧使用另一种缝线。记录的术前数据包括每只手的波士顿腕管问卷（BCTQ）。术后2周记录BCTQ、疼痛视觉模拟评分（VAS）和无菌伤口评分。术后6周，重复记录BCTQ和VAS，并进行患者和观察者瘢痕评估量表（POSAS）评分。询问患者对左或右缝线的偏好。使用线性混合模型进行统计分析，评估BCTQ的改善情况以及缝线之间的伤口评分。使用非参数Wilcoxon符号秩检验比较各个量表。评估包括年龄、合并症和既往类固醇注射在内的特定患者因素对结果的影响。
在任何总体记录评估、并发症或患者偏好方面，两种缝线类型之间均无显著差异。术后BCTQ评分显著改善，P = 0.001。既往类固醇注射、糖尿病和65岁以上年龄不影响结果。
可以告知患者，开放式腕管减压术后使用可吸收或不可吸收缝线材料进行皮肤缝合，其结果没有差异。
