Absorbable versus non-absorbable sutures for skin closure after carpal tunnel decompression surgery

Area of Science:

• Orthopedic Surgery
• Surgical Techniques
• Wound Closure

Background:

• Carpal tunnel syndrome is common, with surgical decompression being the most effective treatment.
• Skin closure after surgery can use absorbable or non-absorbable sutures, but evidence on the ideal choice is conflicting.

Purpose of the Study:

• To assess outcomes of absorbable versus non-absorbable sutures for skin closure after carpal tunnel decompression.
• Outcomes evaluated include postoperative pain, hand function, scar satisfaction, wound inflammation, and adverse events.

Main Methods:

• A systematic review and meta-analysis of randomized or quasi-randomized controlled trials.
• Searched multiple databases up to October 2017, including Cochrane Neuromuscular, CENTRAL, MEDLINE, and Embase.
• Assessed evidence quality using GRADE, with primary outcome as postoperative pain.

Main Results:

• Five trials (255 participants) were included, all with high risk of bias and very low-quality evidence.
• Little to no difference in postoperative pain was found between suture types, but results were highly uncertain.
• Evidence on wound inflammation, hand function, and scar satisfaction was also very low quality and uncertain.

Conclusions:

• It is uncertain whether absorbable or non-absorbable sutures are superior for carpal tunnel decompression due to very low-quality evidence.
• Absorbable sutures eliminate the need for removal, potentially saving costs.
• Rigorous non-inferiority randomized trials with economic analyses are needed to guide suture choice.