Trigger Finger Release: Are Sutures Requiring Removal Necessary?

Tiffany N Bridges; Alexis A Kasper; Matthew B Sherman; Jonas L Matzon; Asif M Ilyas

doi:10.1016/j.jhsg.2023.06.010

Trigger Finger Release: Are Sutures Requiring Removal Necessary?

J Hand Surg Glob Online. 2023 Aug 4;5(6):740-743. doi: 10.1016/j.jhsg.2023.06.010. eCollection 2023 Nov.

Authors

Tiffany N Bridges¹, Alexis A Kasper², Matthew B Sherman², Jonas L Matzon², Asif M Ilyas²

Affiliations

¹ Department of Orthopaedic Surgery, Jefferson Health New Jersey, Stratford, NJ.
² Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA.

Abstract

Purpose: There is no consensus regarding optimal closure for trigger finger release (TFR) surgery. The purpose of this study was to compare the number of postoperative visits and complications following TFR closure with nonabsorbable sutures versus those following TFR closure with absorbable sutures and skin glue. The hypothesis was that wound closure with absorbable sutures and glue will result in fewer postoperative visits, while having similar complication rates as that with nonabsorbable sutures.

Methods: A retrospective review identified all patients undergoing open TFR over a 3-year period performed by two hand surgery fellowship-trained hand surgeons who adhered to an identical surgical protocol except for incisional closure. Patients were divided into two groups: a control group with nonabsorbable 4-0 monofilament sutures requiring removal ("suture" group) and a study group with buried absorbable 4-0 monofilament sutures not requiring removal as well as skin glue ("glue" group). The data collected included age, sex, number of postoperative visits, wound complications, infections, antibiotic use, prescribed hand therapy, hospital admission, and reoperation.

Results: A total of 305 open TFR surgeries in 278 patients were included in the study, with 155 digits in the "suture" group and 150 in the "glue" group. Both groups were similar in age and sex. The "suture" group had significantly more total postoperative visits (185 vs 42, respectively, P < .001) and postoperative visits within the first 2 weeks (155 vs 10, respectively, P < .001) than the "glue" group. Additional postoperative visits beyond 2 weeks of surgery were similar between the two groups. Three (1.9%) patients in the "suture" group and two (1.3%) patients in the "glue" group developed a superficial surgical site infection within 30 days after surgery. Neither had deep infections requiring hospitalization or reoperation. Both groups required similar rates of postoperative hand therapy.

Conclusions: Absorbable sutures afford fewer postoperative visits while having a similar complication rate as nonabsorbable sutures requiring removal.

Type of study/level of evidence: Therapeutic IV.

Keywords: Absorbable suture; Monocryl; Nonabsorbable suture; Prolene; Trigger finger release.