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Comparison of Postoperative Outcomes After Trigger Finger Release Closed by Absorbable and Non-Absorbable Sutures: A Systematic Review and Meta-Analysis.
Bayan Ghalimah, MBBS, FRCSC
1; Danah Sandagji, Medical Student
2(1)King Abdulaziz University, Jeddah, SA, Saudi Arabia, (2)Taibah University, Nadinah, SA, Saudi Arabia
Abstract:Introduction: Stenosing flexor tenosynovitis, or trigger finger, is a common condition characterized by finger catching, clicking, or locking due to inflammation of the retinacular sheath
[1,6,7]. First described by Notta in 1850
[2], it results from a mismatch between the flexor tendon and its sheath, restricting motion
[3-5]. While the etiology remains unclear, repetitive movements, trauma, and systemic conditions like diabetes and rheumatoid arthritis are implicated
[9-15]. Treatment ranges from conservative measures to A1 pulley release surgery
[11,17-19]. This study compares postoperative outcomes between absorbable and non-absorbable sutures after trigger finger release surgery.
Methodology: A comprehensive literature search was conducted in PubMed and the Cochrane Library using the "MeSH" terms and free text terms related to "trigger finger," "stenosing tenosynovitis," and management strategies. Six independent reviewers screened the results using Rayyan.ai, with conflicts resolved by a seventh reviewer. Full texts of potentially eligible studies were assessed based on predefined criteria, including randomized controlled trials, cohort studies, case-control studies, case reports, and observational studies on adult patients undergoing surgical release for trigger finger. Exclusions were made for studies involving patients under 18, lacking relevant outcomes, or being of low quality or duplicates. Data extraction was standardized to collect study characteristics, patient demographics, suture types, outcomes, and statistical methods, with discrepancies resolved through discussion with a research supervisor.
Results: Patients with absorbable sutures had significantly higher odds of dehiscence (OR: 2.83, P=0.02). Although absorbable sutures were also associated with a higher odd of infection (OR: 1.49), this result lacked statistical significance (P=0.29). Similarly, the odds of requiring antibiotics were higher with absorbable sutures (OR: 1.17), but not statistically significant (P=0.74). In contrast, nonabsorbable sutures showed a lower odd of wound problems (OR: 0.76), which was significant (OR: 0.42, P=0.004). Overall, absorbable sutures are associated with increased dehiscence and complications, while nonabsorbable sutures are associated with lower risk of wound complications.
Conclusion: Our meta-analysis found that absorbable sutures significantly increased the risk of wound dehiscence after trigger finger release compared to nonabsorbable sutures. these differences were not statistically significant. Nonabsorbable sutures were associated with fewer wound complications, with significance confirmed after sensitivity analysis. These findings suggest that nonabsorbable sutures may be preferable for reducing wound-related issues, though further studies are needed to guide suture selection.
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