Abstract
BackgroundThere are various skin suture techniques for wound closure following carpal tunnel release, and well-performed suturing will result in low post-operative scar tenderness. The aim of this study was to compare the Donati suture technique and running subcuticular technique in terms of surgical scar, post-operative pain and functional outcome in open carpal tunnel release.MethodsOne-hundred forty-two patients were randomized using a computer-generated random number table into two groups receiving either running subcuticular suturing or Donati suturing after surgical intervention. We evaluated postoperative scarring using the Patient and Observer Scar Assessment Scale (POSAS), pain intensity using a verbal numerical rating scale, and functional outcomes using the Thai version of the Boston Carpal Tunnel Questionnaire after surgical decompression for carpal tunnel syndrome at 2, 6, and 12 weeks. Continuous data are reported as mean ± SD while normally distributed or as median (interquartile range) when the distribution was skewed.ResultsLower scores at 2 weeks were given by the patients receiving the running subcuticular suture technique than the Donati suture technique (15.3 ± 4.8 vs 17 ± 4.6, respectively, P < 0.05) while the observer scores were not significantly different (15.6 ± 5.8 vs 16.7 ± 5.2, respectively, P = 0.15). At both 6 and 12 weeks post-surgical decompression both patient and observer scores were not significantly different. There were no differences between the groups in terms of VNRS pain scores and functional Boston Carpal Tunnel Scores at all time points.ConclusionsThis randomized controlled trial found that although scarring assessments were slightly better in the earliest period following wound closure after surgical decompression in carpal tunnel syndrome using the running subcuticular suture, the final results at 3 months postoperative were not significantly different.Trial registrationThe study was registered at https://www.thaiclinicaltrials.org/ (TCTR20191204002).
Highlights
Carpal tunnel syndrome (CTS) is the most common nerve entrapment syndrome [1]
There are various skin suture techniques for wound closure following carpal tunnel release, and wellperformed suturing will result in low post-operative scar tenderness
A total of 142 participants affected by idiopathic CTS, 71 assigned to the Donati suture group and 71 to the running subcuticular suture group, were included in the study and underwent open carpal tunnel release from March 2018 to December 2020
Summary
Carpal tunnel syndrome (CTS) is the most common nerve entrapment syndrome [1]. The treatment is always either surgical or conservative. Surgery-related complications include tender scar, persistent symptoms, neurovascular injury, wound complications, bleeding, pillar pain (a deep aching pain at the base of the thenar eminence and across the wrist), and/ or reduced grip strength. Most of these occur only rarely, in the order of
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