Abstract
Aims: To compare wound closure using a subcuticular (4/0 PDS) with an interrupted (4/0 Nylon) in open carpal tunnel decompression (CTD).
Methods: 78 patients (22 bilateral) were recruited prospectively and randomised when consenting for the trial. All operations were performed by a single surgeon (JW). Patients were reviewed at 2 weeks and 3 months. Patients graded scar appearance on a four-point scale, and digital photographs were taken. Patients scored discomfort level for suture removal, on a Visual Analogue Scale (VAS1–10) and a four-point categorical scale. Three consultant hand surgeons graded the digital photographs, using the same scale as the patients.
Results: Patients preferred the appearance of the subcuticular closure at 2 weeks (p=0.002); there was no statistical difference by 3 months. There was a trend towards patients þnding subcuticular suture removal less painful. Assessment of scar appearance by the consultants at 2 weeks signiþcantly favoured subcuticular closure (Cons. A: p= < 0.001, Cons. B: p=0.001, Cons. C: p=0.001); there was no signiþcant difference at 3 months. The bilateral cases preferred scar appearance following subcuticular suture (p=0.001).
Conclusions: Wound closure in open CTD using subcuticular PDS is safe. Patients and surgeons initially preferred the appearance of the subcuticular scar, when compared to closure with interrupted Nylon. Patients also experienced less pain during subcuticular PDS suture removal.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
