Prospective randomized controlled trial comparing the effect of Monocryl versus nylon sutures on patient- and observer-assessed outcomes following carpal tunnel surgery.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2024;12(5):7 J Hand Surg Eur Vol . 2023 Nov;48(10):1014-1021.What this means for my practice?
Early postoperative scar appearance and patient satisfaction favor Monocryl sutures, suggesting potential benefits for optimizing patient perception during the critical initial recovery period. However, these differences diminish over time, and long-term outcomes may not differ substantially between Monocryl and nylon closures. The study limitations include the relatively short follow-up and potential biases associated with scar assessments. In addition, the study acknowledges that it is underpowered to be able to detect potential differences in patient and observer scar assessment scales between Monocryl and nylon at the 6-week follow-up.
Study Summary
One hundred twenty-five patients undergoing open carpal tunnel release were prospectively randomized to receive either interrupted, buried Monocryl sutures or traditional nylon horizontal mattress sutures. Primary outcomes focused on scar assessment using the Patient and Observer Scar Assessment Scale (POSAS) questionnaires which were completed at 2 and 6 weeks postoperatively. As a result, Monocryl sutures demonstrated superiority in early scar appearance, with notable differences in thickness, irregularity, and overall positive opinion by both patients and observers at 2 weeks. However, overall, scar satisfaction assessments converged between the Monocryl and nylon groups at the 6-week mark.
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