PDF(Pubmed)
Abstract：
Background Carpal tunnel syndrome (CTS) is caused by compression of the median nerve in the carpal tunnel. The effect of tissue adhesives as a material for wound closure following CTS decompression has been insufficiently investigated. This study aimed to evaluate outcomes by comparing two modalities of wound closure following carpal surgery in patients randomly assigned to either tissue adhesives or sutures. Methodology This randomized, prospective study was conducted in April 2022 at the University Hospital of Split in Croatia. Patients aged 61.56 ± 12.03 years were randomized to either tissue adhesive Glubran Tiss 2®-based (n = 50) or suture-based (n = 50) wound-closure techniques. The following outcomes were assessed before surgery and six months postoperatively: hand strength, electroneurographic characteristics of the median nerve, and the Boston Carpal Tunnel Questionnaire. Results Significant differences between glue-based and suture-based wound-closure techniques were found in the six-month postoperative hand grip strength (25.06 ± 6.69 vs. 21.41 ± 5.62 kg; p = 0.002), postoperative sensory amplitude (10.08 ± 5.50 vs. 7.54 ± 5.41 mV; p = 0.012), and postoperative sensory velocity (42.22 ± 11.04 vs. 35.23 ± 16.40 m/s; p = 0.008). In the glue-based group, significantly more patients achieved a postoperative sensory velocity greater than 45 m/s (47.9% vs. 22.0%; p= 0.006), postoperative distal sensory latency less than 3.5 ms (89.6% vs. 84.0%; p = 0.304), and postoperative motor latency of less than 4.2 ms (60.42% vs. 38.00%; p = 0.022). Conclusions This trial demonstrated that cyanoacrylate-based adhesion material for wound closure after open CTS decompression compared with sutures showed a significant six-month postoperative increment in hand grip strength and median nerve sensory conduction.
摘要：
背景腕管综合征（CTS）是由腕管正中神经受压引起的。尚未充分研究组织粘合剂作为CTS减压后伤口闭合材料的作用。这项研究旨在通过比较随机分配给组织粘合剂或缝合线的患者腕骨手术后两种伤口闭合方式来评估结果。方法学随机，前瞻性研究于2022年4月在克罗地亚斯普利特大学医院进行。年龄为61.56±12.03岁的患者被随机分配到基于组织粘合剂GlrubranTiss2®（n=50）或基于缝合线（n=50）的伤口闭合技术。在手术前和术后6个月评估以下结果：手力量，正中神经的神经电图特征，波士顿腕骨隧道调查问卷.结果基于胶水和基于缝合的伤口闭合技术在术后六个月的手握力方面存在显着差异（25.06±6.69vs.21.41±5.62千克；p=0.002），术后感觉振幅(10.08±5.50vs.7.54±5.41mV；p=0.012），和术后感觉速度(42.22±11.04vs.35.23±16.40m/s；p=0.008）。在基于胶水的组中，明显更多的患者术后感觉速度大于45m/s（47.9％vs.22.0%；p=0.006)，术后远端感觉潜伏期小于3.5ms（89.6%vs.84.0%；p=0.304），术后运动潜伏期小于4.2ms(60.42%vs.38.00%；p=0.022）。结论该试验表明，与缝线相比，开放式CTS减压后基于氰基丙烯酸酯的粘连材料用于伤口闭合，在手握力和正中神经感觉传导方面显示出明显的术后六个月增加。
