Suture Types for Carpal Tunnel and Trigger Finger Surgery

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Mayo Clinic

Disqualifiers: Revision surgery, Prior surgery, Dupuytren's, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

Duration: 1-2 weeks

130 Participants Needed

Trial Summary

What is the purpose of this trial?

Does a difference in patient satisfaction and cosmetic outcome exist between wound closure with absorbable or non-absorbable sutures.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of different suture types for wound closure in carpal tunnel and trigger finger surgery?

Research shows that using Monocryl sutures for wound closure in carpal tunnel and trigger finger surgeries results in fewer complications like wound dehiscence (wound reopening) and infections compared to nylon and chromic sutures. However, there is no significant difference in overall outcomes between absorbable and non-absorbable sutures in these surgeries. ^{1 2 3 4 5}

Are sutures safe for carpal tunnel and trigger finger surgery?

Sutures are generally safe for carpal tunnel and trigger finger surgeries, but the type of suture can affect the risk of complications. Monocryl sutures showed lower rates of wound problems like infection and reopening compared to nylon and chromic gut sutures. Absorbable sutures may lead to more wound complaints but have similar overall outcomes to non-absorbable sutures. ^{1 2 3 4 6}

How does the treatment of wound closure with different suture types for carpal tunnel and trigger finger surgery differ from other treatments?

The treatment of wound closure using different suture types, such as absorbable and non-absorbable sutures, is unique because it focuses on the method of closing the surgical incision rather than the surgery itself. This approach aims to reduce complications like wound dehiscence (reopening of the wound) and infection, with some studies suggesting that certain sutures like Monocryl may lead to better outcomes compared to others like nylon or chromic gut. ^{1 2 4 5 6}

Research Team

Peter C Rhee, DO, MS

Principal Investigator

Mayo Clinic

Eligibility Criteria

This trial is for adults 18 years or older who are having their first carpal tunnel release or trigger finger pulley release surgery. It's not for those who've had previous surgeries on the same hand or have Dupuytren's disease.

Inclusion Criteria

You recently had surgery for carpal tunnel or trigger finger.

Exclusion Criteria

Patient identified outside of the proposed study time period

You have had a previous surgery to fix a problem.

You have had surgery on the same hand or fingers before.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants are randomized to wound closure with either absorbable or non-absorbable sutures

1-2 weeks

Follow-up

Participants are monitored for scar formation and cosmetic outcomes using POSAS and PRWHE

1 year

Treatment Details

Interventions

• Wound closure

Trial Overview The study is testing whether there's a difference in patient satisfaction and how scars look when using absorbable versus non-absorbable stitches after surgery for carpal tunnel syndrome or trigger finger.

Participant Groups

Group I: Absorbable suture Experimental Treatment 1 Intervention

Wound closure with absorbable suture.

Group II: Non-absorbable suture Active Control 1 Intervention

Wound closure with non-absorbable suture.

Who Is Running the Clinical Trial?

Mayo Clinic

Lead Sponsor

Trials

3,427

Recruited

3,221,000+

Findings from Research

In a study of 53 patients undergoing carpal tunnel decompression, both absorbable (Vicryl Rapide) and nonabsorbable (Prolene) sutures showed similar outcomes in terms of functional recovery and patient satisfaction, with no significant differences in QuickDASH and VAS scores at 6 weeks post-surgery.

Both suture types were found to be safe, with no complications reported, and all but one patient achieved excellent wound healing by 6 weeks, suggesting that surgeons can choose either type based on personal preference and handling characteristics.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical outcome and wound healing following carpal tunnel decompression: a comparison of two common suture materials. MacFarlane, RJ., Donnelly, TD., Khan, Y., et al.[2021]

In a randomized trial involving 40 hands from 33 patients, absorbable and non-absorbable sutures showed no significant difference in outcomes such as pillar pain, scar tenderness, or wound inflammation after open carpal tunnel release surgery.

Both suture types resulted in similar improvements in symptoms and functional status, as assessed by the Boston Questionnaire at 2, 6, and 12 weeks post-surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Prospective randomized trial comparing absorbable and non-absorbable sutures in open carpal tunnel release. Kharwadkar, N., Naique, S., Molitor, PJ.[2009]

A study of 329 patients undergoing trigger finger release found that using a telemedicine follow-up protocol with absorbable sutures resulted in similar clinical outcomes compared to traditional in-office follow-ups.

However, patients with absorbable sutures reported more wound complaints, indicating a potential trade-off in patient satisfaction despite comparable effectiveness in recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Absorbable Sutures and Telemedicine for Patients Undergoing Trigger Finger Release. Holbert, SE., Brown, C., Baxter, S., et al.[2023]

In a study of 312 patients undergoing carpal tunnel and trigger finger release surgeries, incisions closed with Monocryl suture had significantly lower rates of wound dehiscence (2.1%) and infection (1.6%) compared to nylon (10.5% dehiscence, 7.4% infection) and chromic gut (10.3% dehiscence, 13.8% infection).

The analysis indicated that Monocryl not only reduced complications but also led to fewer additional wound-related encounters (8.0%) compared to nylon (16.8%) and chromic gut (24.1%), prompting its adoption as the standard suture type for these procedures at the Palo Alto Veterans Affairs Health Care System.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Which Stitch? Replacing Anecdote with Evidence in Minor Hand Surgery. Rochlin, DH., Sheckter, CC., Curtin, CM.[2020]

A systematic review of five trials involving 255 participants found no clear evidence that absorbable sutures are better or worse than non-absorbable sutures for skin closure after carpal tunnel decompression surgery, indicating very low-quality evidence.

While absorbable sutures eliminate the need for removal, which could save time and costs, the overall effectiveness and safety of either suture type remain uncertain, highlighting the need for more rigorous studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Absorbable versus non-absorbable sutures for skin closure after carpal tunnel decompression surgery. Wade, RG., Wormald, JC., Figus, A.[2022]

In a study of 47 patients undergoing carpal tunnel release surgery, using a vessel loop in wound closure significantly improved patient satisfaction during suture removal, with a satisfaction score of 9.9 compared to 8.6 in the standard closure group.

The vessel loop technique also reduced pain and time for suture removal, with pain scores of 0.68 versus 2.6 and removal times of 31 seconds compared to 84 seconds in the standard group, indicating a more efficient and comfortable experience for patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Including a Vessel Loop in Wound Closure Facilitates Suture Removal Following Open Carpal Tunnel Release. Frazier, MC., Tomooka, LBH., Foeger, N., et al.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

Clinical outcome and wound healing following carpal tunnel decompression: a comparison of two common suture materials. [2021]

2. Scotland pubmed.ncbi.nlm.nih.gov

Prospective randomized trial comparing absorbable and non-absorbable sutures in open carpal tunnel release. [2009]

3. United States pubmed.ncbi.nlm.nih.gov

Absorbable Sutures and Telemedicine for Patients Undergoing Trigger Finger Release. [2023]

4. United States pubmed.ncbi.nlm.nih.gov

Which Stitch? Replacing Anecdote with Evidence in Minor Hand Surgery. [2020]

5. England pubmed.ncbi.nlm.nih.gov

Absorbable versus non-absorbable sutures for skin closure after carpal tunnel decompression surgery. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Including a Vessel Loop in Wound Closure Facilitates Suture Removal Following Open Carpal Tunnel Release. [2023]