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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2019; 38(04): 292-296
DOI: 10.1055/s-0037-1603106
Review article | Artigo de Revisão
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

The Influence of the Type of Surgical Thread and Suture in the Open Carpal Tunnel Syndrome Surgery

A influência do tipo de fio cirúrgico e sutura nos resultados da cirurgia aberta da síndrome do túnel do carpo
Marcelo José Silva Magalhães 
1   Department of Neurosurgery, Hospital Vila da Serra, Belo Horizonte, MG, Brazil
2   Department of Medicine, Faculdades Unidas do Norte de Minas and Faculdades Itegradas Pitágoras, Montes Claros, MG, Brazil
,
Beatriz Xavier Cruz
3   Instituto de Ciências da Saúde, Faculdades Unidas do Norte de Minas, Montes Claros, MG, Brazil
,
Fabrício Conceição dos Santos
3   Instituto de Ciências da Saúde, Faculdades Unidas do Norte de Minas, Montes Claros, MG, Brazil
,
Isabella Mendes de Oliveira
3   Instituto de Ciências da Saúde, Faculdades Unidas do Norte de Minas, Montes Claros, MG, Brazil
,
João Pedro Saraiva Sousa
3   Instituto de Ciências da Saúde, Faculdades Unidas do Norte de Minas, Montes Claros, MG, Brazil
,
Thaís de Oliveira Guimarães
3   Instituto de Ciências da Saúde, Faculdades Unidas do Norte de Minas, Montes Claros, MG, Brazil
,
Thiago Antunes Lopes
3   Instituto de Ciências da Saúde, Faculdades Unidas do Norte de Minas, Montes Claros, MG, Brazil
,
Ernesto José Hoffmann
4   Department of Medicine, Instituto de Ciências da Saúde and Faculdades Integradas Pitágoras, Montes Claros, MG, Brazil
› Author Affiliations
Further Information

Publication History

09 January 2017

12 April 2017

Publication Date:
09 May 2017 (online)

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Abstract

Carpal tunnel syndrome (CTS) is the result of compression and/or traction of the median nerve in the carpal tunnel. It is the most frequent compressive neuropathy of the upper limbs and it is usually idiopathic. Diagnosis is essentially clinical, defined by symptoms and provocative tests. Decompression of the median nerve by section of the transverse carpus ligament is the treatment of choice, but the lack of consensus on the type of suture and surgical thread to be used in the open carpal tunnel decompression surgery justifies the importance of evaluating the comparative results of existing studies, aiming to describe the influence of different types of sutures and surgical threads to guide the professionals about the most appropriate conduct. This is a systematic review of the international and national literature. Four studies comparing the influence of surgical threads and one study evaluating the influence of the type of suture were found. From the comparative studies, it was observed that there is advantage in the use of nonabsorbable suture due to the lower occurrence of inflammation and postoperative wound complications. When using Donatti sutures, wound edge inversion is less likely to occur compared with single individual sutures, but they are also related to longer postoperative pain.

Resumo

A síndrome do túnel do carpo (STC) é resultante da compressão e/ou tração do nervo mediano no túnel do carpo. É a mais frequente neuropatia compressiva dos membros superiores e, geralmente, tem causa idiopática. O diagnóstico é essencialmente clínico através dos sintomas e testes provocativos. A descompressão do nervo mediano por secção do ligamento transverso do carpo é o tratamento de escolha, mas a ausência de consenso sobre o tipo de sutura e fio cirúrgico a serem utilizados na cirurgia aberta de descompressão do túnel do carpo justifica a importância de se avaliar os resultados comparativos dos estudos existentes, tendo como objetivo descrever a influência dos diferentes tipos de suturas e fios cirúrgicos e, assim, orientar os profissionais quanto à conduta mais adequada. Trata-se de um estudo de revisão sistemática da literatura internacional e nacional. Foram encontrados quatro estudos comparando a influência dos tipos de fios cirúrgicos e um estudo avaliando a influência do tipo de sutura. A partir dos estudos comparativos, observou-se que a utilização de sutura não absorvível se mostra vantajosa pela menor ocorrência de inflamação e complicações de ferida pós-operatória. Ao utilizar suturas Donatti, a inversão de bordas da ferida é menos provável de ocorrer em comparação com suturas individuais simples, porém estas estão relacionadas com dor pós-operatória mais prolongada.

Keywords

carpal tunnel syndrome - sutures - suture techniques

Palavras-chave

síndrome do túnel do carpo - suturas - técnicas de sutura
 

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