Comparison of the effect of surgical site closure with Monocrly Vs. Nylon sutures on the incidence, severity, and duration of pillar pain and surgical site scar in patients with carpal tunnel syndrome

The aim of this study is to compare the effect of using Monocryl Vs. Nylon sutures for surgical site closure on the incidence, severity, and duration of pillar pain, as well as scar quality in patients undergoing carpal tunnel release surgery.

Randomized, controlled clinical trial with two parallel arms (Monocryl group and Nylon group), double-blinded; the total sample size is 70 patients (35 per arm). randomization will be performed using the EAND function in Excel software.

Study setting: Plastic surgery department of 15th khordad hospital, Tehran; Study population: patients with carpal tunnel syndrome undergoing standard surgery; Blinding: this is a double-blinded study; The patient as well as the individual responsible for postoperative visits, data recording, and statistical analysis are fully blinded to the allocated groups; The surgeon remains unaware of the suture type until the final skin closure to ensure identical technique.

Inclusion criteria: Patients candidate for carpal tunnel release surgery; providing informed consent; Exclusion criteria : Age under 18; diabetes mellitus; systemic diseases affecting wound healing; history of trauma or fracture in the affected hand; recurrent cases of the disease.

Intervention group: surgical site closure using 4-0 Monocryl suture in a subcuticular fashion; Control group: surgical site closure using 4-0 Nylon suture in a subcuticular fashion; other surgical steps are identical in both groups.

Incidence of pillar pain; severity of pillar pain; duration of pillar pain; surgical site scar quality; all will be measured after the surgery.

Simple randomization will be performed in this study. The random sequence will be generated using the RAND function in Microsoft Excel software by an individual not involved in the surgical team. to ensure allocation concealment, sequentially numbered, opaque, sealed envelopes will be used; the intervention type for each patient will be revealed only in the operating room after the envelope is opened by a surgical assistant.

At the end of the operation, exactly before closing the surgical site, the surgeon is informed of the type of suture to be used for the patient. In this way, the surgical technique will be identical in all patients. All postoperative visits, data recording, and data analysis are performed by someone who is unaware of the study's objectives and the groupings.