Simple Suture vs. Vertical Mattress: Choosing the Best Suture for Palmar Incision Based on a Randomized Clinical Trial

Abbas Abdoli Tafti; Milad Gholizadeh

doi:10.18502/jost.v11i3.19406

Abbas Abdoli Tafti Associate Professor, Department of Orthopedics, Trauma Research Center, Shahid Sadoughi Hospital, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Milad Gholizadeh Resident, Department of Orthopedic Surgery, Trauma Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

DOI: https://doi.org/10.18502/jost.v11i3.19406

Keywords: Sutures; Trigger Thumb; Trigger Digits; Carpal Tunnel Release

Abstract

Background: Despite the prevalence of palmar injuries and surgeries, no consensus exists regarding the type of wound closure. The present study compares simple sutures and vertical mattresses sutures in carpal tunnel release (CTR), trigger finger release (TFR), and trigger thumb release (TTR).

Methods: A total of 89 surgeries were randomized to either simple or vertical mattress sutures. Outcomes including pain, infection, Patient and Observer Scar Assessment Scale (POSAS), satisfaction level, and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) were evaluated on postoperative day 3, week 3, and month 3. Month 3 assessments were mostly performed remotely due to coronavirus disease 2019 (COVID-19).

Results: The mean pain was higher in the vertical mattress sutures group compared with simple sutures, though the pain difference was statistically significant only on day 3. No significant mean difference was found between the two groups regarding POSAS items. Some patients underwent bilateral CTR with simple sutures on the one hand and vertical mattresses sutures on the other. The results of their investigation were consistent with the other findings.

Conclusion: Vertical mattress suture in palmar surgeries is associated with greater short-term pain. Other variables did not differ between the two groups at different times. Hence, conclusively, regardless of the short-term pain associated with simple suture, both types of sutures can be used in hand surgeries with similar long-term results.