Comparing the running subcuticular technique versus the Donati technique in open carpal tunnel release: a randomized controlled trial

Abstract Background There are various skin suture techniques for wound closure following carpal tunnel release, and well-performed suturing will result in low post-operative scar tenderness. The aim of this study was to compare the Donati suture technique and running subcuticular technique in terms of surgical scar, post-operative pain and functional outcome in open carpal tunnel release. Methods One-hundred forty-two patients were randomized using a computer-generated random number table into two groups receiving either running subcuticular suturing or Donati suturing after surgical intervention. We evaluated postoperative scarring using the Patient and Observer Scar Assessment Scale (POSAS), pain intensity using a verbal numerical rating scale, and functional outcomes using the Thai version of the Boston Carpal Tunnel Questionnaire after surgical decompression for carpal tunnel syndrome at 2, 6, and 12 weeks. Continuous data are reported as mean ± SD while normally distributed or as median (interquartile range) when the distribution was skewed. Results Lower scores at 2 weeks were given by the patients receiving the running subcuticular suture technique than the Donati suture technique (15.3 ± 4.8 vs 17 ± 4.6, respectively, P < 0.05) while the observer scores were not significantly different (15.6 ± 5.8 vs 16.7 ± 5.2, respectively, P = 0.15). At both 6 and 12 weeks post-surgical decompression both patient and observer scores were not significantly different. There were no differences between the groups in terms of VNRS pain scores and functional Boston Carpal Tunnel Scores at all time points. Conclusions This randomized controlled trial found that although scarring assessments were slightly better in the earliest period following wound closure after surgical decompression in carpal tunnel syndrome using the running subcuticular suture, the final results at 3 months postoperative were not significantly different. Trial registration The study was registered at https://www.thaiclinicaltrials.org/ (TCTR20191204002).

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A Randomized Controlled Trial of Knifelight and Open Carpal Tunnel Release

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhsb.2003.09.001 ◽

2004 ◽

Vol 29 (2) ◽

pp. 113-115 ◽

Cited By ~ 33

Author(s):

R. BHATTACHARYA ◽

P.D. BIRDSALL ◽

P. FINN ◽

J. STOTHARD

Keyword(s):

Randomized Controlled Trial ◽

Carpal Tunnel ◽

Controlled Trial ◽

Carpal Tunnel Release ◽

Symptom Relief ◽

Open Approach ◽

Randomized Controlled ◽

Tunnel Syndrome ◽

Open Carpal Tunnel Release ◽

Bilateral Carpal Tunnel Syndrome

A randomized controlled trial was done to compare the results of carpal tunnel decompression using the standard open approach and the Knifelight® technique. Twenty-six patients with bilateral carpal tunnel syndrome requiring operation were selected for the study and the operative technique was randomized for the first hand. Six weeks later, the second hand was operated upon using the alternate technique. There was little difference between the two techniques with regard to time taken to return to work, return of grip strength, symptom relief, complications, incidence of pillar pain and patient preference. However, the incidence of scar tenderness was significantly lower with the Knifelight® technique.

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Comparison of short wrist transverse open and limited open techniques for carpal tunnel release: a randomized controlled trial of two incisions

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193415603968 ◽

2015 ◽

Vol 41 (2) ◽

pp. 143-147 ◽

Cited By ~ 6

Author(s):

Y. J. Cho ◽

J. H. Lee ◽

D. J. Shin ◽

K. H. Park

Keyword(s):

Randomized Controlled Trial ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Controlled Trial ◽

Carpal Tunnel Release ◽

Open Release ◽

Randomized Controlled ◽

Tunnel Syndrome ◽

Carpal Tunnel Questionnaire

The purpose of this randomized controlled trial was to compare outcomes of limited open and short wrist transverse techniques in patients with carpal tunnel syndrome. In a single centre randomized controlled trial, 84 patients with idiopathic carpal tunnel syndrome were randomized before surgery to limited open or short wrist transverse open carpal tunnel release. The patients were evaluated at 6 weeks, 3 months, 6 months, and 1 and 2 years after surgery. At every follow-up, the Brigham and Women’s Carpal Tunnel Questionnaire scores, scar discomfort, and subjective patient satisfaction were evaluated. Two years after surgery, five patients were lost to follow-up. The groups had similar Brigham and Women’s Carpal Tunnel Questionnaire Symptom Severity and Functional Status scores and subjective satisfaction scores. The incidence of scar discomfort was not significantly different between the two groups on serial postoperative follow-up. Short wrist transverse open release surgery showed similar early postoperative symptoms and subjective and functional outcomes to limited open release. Level of evidence: II

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Cosmetic outcomes and patient satisfaction compared between staples and subcuticular suture technique for wound closure after primary total knee arthroplasty: a randomized controlled trial

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-020-03479-3 ◽

2020 ◽

Vol 140 (9) ◽

pp. 1255-1263

Author(s):

Sarthak Nepal ◽

Pakpoom Ruangsomboon ◽

Pacharapol Udomkiat ◽

Aasis Unnanuntana

Keyword(s):

Total Knee Arthroplasty ◽

Wound Closure ◽

Controlled Trial ◽

Primary Total Knee Arthroplasty ◽

Suture Technique ◽

Subcuticular Suture ◽

Randomized Controlled ◽

Total Knee ◽

Cosmetic Outcomes ◽

Primary Total Knee

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SHORT-TERM RESULTS OF ENDOSCOPIC (OKUTSU METHOD) VERSUS PALMAR INCISION OPEN CARPAL TUNNEL RELEASE: A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL

FUKUSHIMA JOURNAL OF MEDICAL SCIENCE ◽

10.5387/fms.58.49 ◽

2012 ◽

Vol 58 (1) ◽

pp. 49-59 ◽

Cited By ~ 15

Author(s):

SOICHI EJIRI ◽

SHIN-ICHI KIKUCHI ◽

MASATO MARUYA ◽

YASUFUMI SEKIGUCHI ◽

RYOICHI KAWAKAMI ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Carpal Tunnel ◽

Controlled Trial ◽

Carpal Tunnel Release ◽

Short Term ◽

Randomized Controlled ◽

Prospective Randomized Controlled Trial ◽

Open Carpal Tunnel Release

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Evaluation of Carpal Tunnel Release Using the Knifelight® Instrument

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(02)00395-9 ◽

2003 ◽

Vol 28 (3) ◽

pp. 251-254 ◽

Cited By ~ 30

Author(s):

R. H. HELM ◽

S. VAZIRI

Keyword(s):

Carpal Tunnel ◽

Operative Time ◽

Controlled Trial ◽

Carpal Tunnel Release ◽

Randomized Controlled ◽

Open Operation ◽

Prospective Randomized Controlled Trial ◽

Operation Group ◽

Open Carpal Tunnel Release ◽

Palm Of The Hand

We have performed a prospective randomized controlled trial to compare the results of open carpal tunnel release with those of carpal tunnel release using a Knifelight® (Stryker, Kalamazoo, MI). This is a new knife with its own battery-powered light source which enables the operation to be performed through a small incision in the palm of the hand. There were 43 patients in the open operation group and 39 in the Knifelight group. We found no difference in discomfort reported during surgery, in the operative time, in the grip strength measured at 2 and 6 weeks postoperatively or in the proportion of patients cured of their pre-operative symptoms. Patients in the Knifelight group had a statistically significant improvement in the time to return to work and in scar tenderness at 6 weeks post-operatively.

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Endoscopic versus open carpal tunnel release for idiopathic carpal tunnel syndrome: a meta-analysis of randomized controlled trials

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-014-0148-6 ◽

2015 ◽

Vol 10 (1) ◽

pp. 12 ◽

Cited By ~ 50

Author(s):

Dongqing Zuo ◽

Zifei Zhou ◽

Hongsheng Wang ◽

Yuxin Liao ◽

Longpo Zheng ◽

...

Keyword(s):

Carpal Tunnel Syndrome ◽

Randomized Controlled Trials ◽

Carpal Tunnel ◽

Carpal Tunnel Release ◽

Meta Analysis ◽

Controlled Trials ◽

Randomized Controlled ◽

Idiopathic Carpal Tunnel Syndrome ◽

Tunnel Syndrome ◽

Open Carpal Tunnel Release

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Endoscopic Carpal Tunnel Release

Operative Plastic Surgery ◽

10.1093/med/9780190499075.003.0098 ◽

2019 ◽

pp. 989-994

Author(s):

Antony Hazel ◽

Neil F. Jones

Keyword(s):

Carpal Tunnel ◽

Carpal Tunnel Release ◽

Hand Surgery ◽

Anatomical Landmarks ◽

Transverse Carpal Ligament ◽

Palmar Arch ◽

Endoscopic Carpal Tunnel Release ◽

Tunnel Syndrome ◽

Carpal Tunnel Release Surgery ◽

Open Carpal Tunnel Release

Conventional open carpal tunnel release surgery is one of most successful procedures in hand surgery and has been demonstrated to be an effective treatment for carpal tunnel syndrome. However, a known sequelae in some individuals who undergo the procedure is “pillar” pain. In an effort to avoid this condition and help people return to work more quickly, the endoscopic technique was developed. Endoscopic carpal tunnel release offers a minimally invasive alternative to other traditional techniques with similar outcomes. By placing the incision proximal to the transverse carpal ligament there is potential for decreased scar sensitivity and pillar pain. The technique is technically demanding. The superficial palmar arch and common digital nerve to the ring and middle fingers are at risk for injury during the procedure. With adherence to anatomical landmarks and the proper visualization, the surgery may be safely performed.

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