无毛皮肤可吸收缝合线在腕管和扳机指释放后伤口并发症增加

IF 2.2 3区医学 Q3 CRITICAL CARE MEDICINE

Injury-International Journal of the Care of the Injured Pub Date : 2025-06-03 DOI:10.1016/j.injury.2025.112511

Evan Moon , Phillip Ross

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引用次数: 0

摘要

目的在无毛皮肤闭合术中使用可吸收缝合线和不可吸收缝合线尚无明确共识的情况下，本研究的目的是探讨在腕管和扳机指释放手术后，使用Monocryl缝合线闭合的切口是否比尼龙缝合线具有更高的伤口并发症发生率。方法对我院门诊138例155例腕管或扳机指松解术患者的临床资料进行分析。术前有创伤或感染或同时接受手术的患者被排除在外。使用4-0聚甲氨酮25 （Monocryl）或4-0尼龙（Ethilon）关闭切口。采用伪随机方法确定缝线选择：偶日（如4/10/2024）手术采用单缝线，偶日（如4/11/2024）手术采用尼龙缝线。对医疗记录进行了人口统计和术后90天内发生的伤口相关并发症的审查。还评估了Monocryl组和尼龙组之间的额外医疗接触、合共病和辅助住院医师培训水平等标准，以确定并发症发生率的差异。结果腕管松解术86例（55.5%），扳机指松解术69例（44.5%）。平均手术年龄为62.4±11.6岁，其中73例（47.1%）使用Monocryl， 82例（52.9%）使用nylon。Monocryl组（4.1%,n = 3）和nylon组（2.4%,n = 2）需要抗生素的感染率相似。然而，与尼龙（2.4%,n = 2）相比，Monocryl （11.0%, n = 8）的开裂率更高。多变量logistic回归显示，炎症性关节炎、免疫抑制药物使用和初级住院医师协助是伤口并发症的独立预测因素。结论在腕管术后使用Monocryl缝合线和触发指松解术可提高腕管术后90天内的骨折破裂率。此外，住院医师培训水平、免疫抑制和炎症性关节炎等因素与并发症增加有关。研究类型/证据水平

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Increased wound complications in glabrous skin with absorbable sutures following carpal tunnel and trigger finger release

Purpose

With no clear consensus on absorbable verses non-absorbable suture-usage for glabrous skin closures, the purpose of this study was to investigate whether incisions closed with Monocryl sutures displayed higher wound complication rates than nylon sutures following carpal tunnel and trigger finger release surgery.

Methods

A total of 155 carpal tunnel or trigger finger release surgeries in 138 patients performed in an outpatient academic medical center were analyzed. Patients with pre-operative trauma or infection, or who received concurrent surgeries were excluded. Incisions were closed using either 4–0 poliglecaprone 25 (Monocryl) or 4–0 nylon (Ethilon). Suture choice was determined via a pseudo-randomized method: Monocryl sutures were utilized in surgeries performed on even dates (e.g. 4/10/2024) and nylon sutures on odd dates (e.g. 4/11/2024). The medical records were reviewed for demographics and wound-related complications occurring within 90 days post-surgery. Criteria including additional medical encounters, co-morbidities, and assisting resident level-of-training between Monocryl and nylon cohorts were also evaluated for differences in complication rates.

Results

There were 86 carpal tunnel release (55.5 %) and 69 trigger finger release (44.5 %) surgeries. The average age at surgery was 62.4 ± 11.6 years, with Monocryl used in 73 (47.1 %) and nylon in 82 (52.9 %) procedures. The rates of infection requiring antibiotics were similar between Monocryl (4.1 %, n = 3) and nylon cohorts (2.4 %, n = 2). However, higher rates of dehiscence were observed with Monocryl (11.0 %, n = 8) compared to nylon (2.4 %, n = 2). Multivariable logistic regression showed that inflammatory arthritis, immunosuppressant drug use, and junior resident assistance were independent predictors of wound complications.

Conclusion

In conclusion, we found usage of Monocryl sutures following carpal tunnel and trigger finger release associated with higher a dehiscence rate within 90 days post-operation. Additionally, factors including resident training level, immunosuppression, and inflammatory arthritis were associated with increased complications.

Type of Study/Level of Evidence

Therapeutic IV

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来源期刊

Injury-International Journal of the Care of the Injured 医学-急救医学

CiteScore

4.00

自引率

8.00%

发文量

699

审稿时长

96 days

期刊介绍： Injury was founded in 1969 and is an international journal dealing with all aspects of trauma care and accident surgery. Our primary aim is to facilitate the exchange of ideas, techniques and information among all members of the trauma team.