A comparison of patient experience with and preference for absorbable and unabsorbable suture for skin closure following carpal tunnel release surgery.

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Aim:To determine whether there is a clinical or patient preference in skin closure after carpal tunnel surgery using an Absorbable (Vicryl Rapide) or Non-absorbable suture material. Introduction: There are reported benefits of both sutures. The absorbable suture will not need removal with the potential to reduce hospital visits after surgery but the reaction to the suture is said to vary between people. The non-absorbable suture is said to be more inert with less patient reaction but requires removal. Methods: Patients will be given an approved information sheet and will sign a consent. Consenting Patients undergoing staged or simultaneous bilateral carpal tunnel surgery will have a preoperative assessment with questionnaire assessing ASA grade, BMI screen for other medical problems including inflammatory arthropathy, diabetes, immunosuppressive medication, smoking status, whether nerve conduction studies or local steroid injection has been performed. They will complete a Boston Carpal Tunnel Questionnaire (BCTQ)for each hand. They will choose which hand they wish to be done first, will be assigned a study number which will randomly allocate a suture to each hand. The surgery is the same on both sides in all respects apart from the closing suture used. The patient is blinded to the suture used on each side. For patient convenience surgery is usually staged with a minimum interval of two weeks but may be extended if other factors dictate for example pregnancy. The interval between surgeries however must fall within the anticipated time period of the study otherwise the patient will be excluded from the study. Patients will be reviewed at 2 and finally at 6 weeks post-operatively. At 2 weeks the BCTQ is repeated an ASEPSIS and 10-point Likert Pain Scale is recorded before the wound dressing is disturbed. At 6 weeks the BCTQ and Likert Scale are repeated, in addition a 7-point POSAS Observer and Patient Scale are performed. The patient is asked which suture they preferred, that used on the Left or Right or did they have no preference. Any complications are recorded. Responses will be entered into a data base where patient identification will be by Study Number only.