gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Endoscopic carpal tunnel release with or without a suture. Is there a difference?

Meeting Abstract

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  • presenting/speaker Iwein Piepers - AZ Sint Jan, Brugge, Belgium
  • Jean Goubau - AZ Sint Jan, Brugge, Belgium
  • Francis Bonte - AZ Sint Jan, Brugge, Belgium
  • Bert Vanmierlo - AZ Sint Jan, Brugge, Belgium

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-222

doi: 10.3205/19ifssh0568, urn:nbn:de:0183-19ifssh05683

Veröffentlicht: 6. Februar 2020

© 2020 Piepers et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objectives/Interrogation: In our department surgical treatment of Carpal tunnel syndrome is performed using, the single incision technique described by Agee. It is a transverse incision of about 1 cm carefully placed into the skinfold of the palmar wrist. In our practice, we faced 2 cases where the skin suture was removed accidently the day following surgery. We left the wound open and protected it with wound closure strips. The skin healed remarkably well. We therefore set up, after approval of the ethics committee, a randomized study to compare the evolution of wound healing with or without skin suture in patients undergoing an endoscopic carpal tunnel release as treatment for carpal tunnel syndrome. Primary outcome is the Manchester Scar Scale (MSS).

Methods: 159 patients were recruited between April 2016 and April 2017. Inclusion criteria were patients with clinical and electrographic confirmation by the Canterbury NCS Scale of a carpal tunnel syndrome. Age, gender, occupation, predominant hand and the side of the operation were noted.

In the first group (64 patients) the skin was not sutured. In the second group (44 patients) the skin was intracutaneously sutured with ethilon 5-0. Data from 108 patients till 3 months postoperatively could be acquired.

Results and Conclusions: Since the data were not normally distributed the analysis was done with the Independent Samples Mann-Whitney U test (MWU). There is no significant difference in age (p=0.496), gender (p=0.670) and occupation (p=0.725). The scar assessment using the MSS did not differ significantly between both groups: The MWU test is used, p=0.607. In the non-suture group, the MSS was 6.59 (standard deviation 1.294) and in the suture group the MSS was 6.45 (standard deviation 1.088).

Postoperatively wound healing and scar appearance with or without a suture is a topic that has not yet been addressed in the literature. In this study, the outcome of the scar 3 months postoperatively using the MSS is similar in both groups.

Wound closing without a suture can be considered as a valuable option in treating carpal tunnel syndrome using a single portal endoscopic technique.