Tissue Adhesive versus Skin Suture plus Waterproof Wound Dressings for Carpal Tunnel Wound Closure: A Prospective Randomized Controlled Trial
https://doi.org/10.5704/MOJ.2407.009
- Author:
Maneesrisajja T
1
;
Srikulawong K
1
Author Information
1. Department of Orthopaedics, Nongkhai Hospital, Nong Khai, Thailand
- Publication Type:Journal Article
- Keywords:
carpal tunnel decompression, skin closure, tissue adhesive glue, skin suture, clinical outcomes
- From:Malaysian Orthopaedic Journal
2024;18(No.2):63-70
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: The popular wound closure methods for
carpal tunnel decompression (CTD) include non-absorbable
and absorbable sutures which have comparable results in
clinical outcomes. However, these wound closure methods
are recommended to keep a wound dry which may limit
some ADLs. We conducted a prospective randomized
controlled trial that compares clinical outcomes and costeffectiveness in a skin closure following CTD between
absorbable sutures plus a 2-octyl cyanoacrylate tissue
adhesive (2OCA) versus non-absorbable skin sutures plus a
waterproof dressing (NSPWD).
Materials and methods: We enrolled 120 patients
undergoing CTD into two groups: 2OCA and NSPWD, with
60 patients in each group. Number of dressing changes,
Quick DASH, pain VAS, cosmetic VAS, patient satisfaction
VAS, and Hollander wound evaluation score, costeffectiveness, and post-operative complications were
collected at pre-operative period and two and six weeks postoperatively.
Results: Slightly better patient satisfaction VAS (7.9 vs 7.2,
p=0.018) and cosmetic VAS (8.0 vs 7.2, p=0.025) were
observed in 2OCA at 2 weeks. Meanwhile, NSPWD revealed
lesser times of dressing change (Median, mode, IQR: 0/0/0
vs 2/3/2, p<0.001). The total wound-related costs include
dressing change and suture removal cost ($15.9 for 2OCA vs
$19.2 for NSPWD, p=0.002) although an initial woundrelated cost in 2OCA was higher ($15.7/case vs $7.9/case,
p<0.001).
Conclusions: Our study revealed that the supplementary
tissue adhesive to absorbable sutures following CTD could
reduce total wound-related costs while clinical outcomes
might not be considered clinically significant.
- Full text:202408211540109968216.2024my1374.pdf
