Suture Choice After Carpal Tunnel Release — Religion or Science?
It can, and should, be science — and patients can guide us here
![Suture Choice After Carpal Tunnel Release — Religion or Science?](/content/images/size/w1200/2024/04/Ghost-banner-image--8-.png)
What’s the Claim?
We almost hesitated to cover this because surgeons’ approaches to closing incisions sometimes seems more like religion than science, but ours is a scientific discipline, so here goes . . .
A randomized clinical trial compared closure with interrupted nonabsorbable suture to interrupted absorbable suture (buried 4-0 Moncryl dermal sutures versus 4-0 nylon horizontal mattress sutures) in patients undergoing open carpal tunnel release, and found at 2 weeks after surgery:
- Patients rated the absorbable closure as preferable in terms of scar thickness, irregularity, and total score (using the validated Mean Patient Scar Assessment Scale)
- The between-group differences probably were large enough to be considered clinically important
- There were no differences in terms of pain, itching, color, or stiffness
- Independent observers (not the surgeons themselves) rated the absorbable closures as superior in all metrics
- The between-group differences generally were small and may not have been clinically important
There were no between-group differences at 6 weeks after surgery, but there’s still something you can use here, so read on.