Penrose Drain for Carpal Tunnel Release: A Randomized Controlled Trial
Abstract
Background: Surgical site hematoma is one of the factors that influences the results of the carpal tunnel release and patients’ satisfaction ; therefore, this study was designed to evaluate the effects of using Penrose drain in order to reduce the operation site hematoma and improve the results of surgery.
Methods: Patients with a diagnosis of carpal tunnel syndrome (CTS) were randomly divided into intervention and control group and then were evaluated by pain with Visual Analog Scale (VAS) and Pinch power. Penrose drain was placed for the intervention group and removed after two days. Three months after surgery, all patients were re-evaluated by VAS and pinch power, and then the collected data were analyzed statistically using the Wilcoxon Signed Ranks Test by SPSS.
Results: Out of 46 patients, Penrose drain was placed for 21 patients. According to the results, the VAS and Pinch power evaluations were better in patients with Penrose drain (P-value = 0.001) but in patients without Penrose drain, only the VAS evaluation results were improved, but a decrease in Pinch powers was detected.
Conclusion: The results showed that CTR surgery with or without the Penrose drain decreases pain in patients after three months of operation. CTR with Penrose drain improve Pinch power and also decreases the pain, but in patients without Penrose drain, Pinch power was reduced after this period.
2. Gelfman R, Melton LJ3rd, Yawn BP, Wollan PC, Amadio PC, Stevens JC. Long-term trends in carpal tunnel syndrome. Neurology. 2009;72(1):33-41. doi: 10.1212/01.wnl.0000338533.88960.b9. [PubMed: 19122028]. [PubMed Central: PMC2633642].
3. Pourmemari MH, Heliovaara M, Viikari-Juntura E, Shiri R. Carpal tunnel release: Lifetime prevalence, annual incidence, and risk factors. Muscle Nerve. 2018;58(4):497-502. doi: 10.1002/mus.26145. [PubMed: 29665085].
4. Piazzini DB, Aprile I, Ferrara PE, Bertolini C, Tonali P, Maggi L, et al. A systematic review of conservative treatment of carpal tunnel syndrome. Clin Rehabil. 2007;21(4):299-314. doi: 10.1177/0269215507077294. [PubMed: 17613571].
5. Hutchinson DT, Wang AA. Releasing the tourniquet in carpal tunnel surgery. Hand (N Y). 2010;5(1):57-9. doi: 10.1007/s11552- 009-9202-y. [PubMed: 19472015]. [PubMed Central: PMC2820624].
6. Azar FM, Canale ST, Beaty JH. Campbell's operative orthopaedics. Philadelphia, PA: Elsevier; 2020.
7. Schnetzler KA. Acute carpal tunnel syndrome. J Am Acad Orthop Surg. 2008;16(5):276-82. doi: 10.5435/00124635- 200805000-00006. [PubMed: 18460688].
8. Duncan KH, Lewis RC, Jr., Foreman KA, Nordyke MD. Treatment of carpal tunnel syndrome by members of the American Society for Surgery of the Hand: Results of a questionnaire. J Hand Surg Am. 1987;12(3):384-91. doi: 10.1016/s0363- 5023(87)80011-4. [PubMed: 3584886].
9. Neuhaus V, Christoforou D, Cheriyan T, Mudgal CS. Evaluation and treatment of failed carpal tunnel release. Orthop Clin North Am. 2012;43(4):439-47. doi: 10.1016/j.ocl.2012.07.013. [PubMed: 23026459].
10. Langley GB, Sheppeard H. The visual analogue scale: Its use in pain measurement. Rheumatol Int. 1985;5(4):145-8. doi: 10.1007/BF00541514. [PubMed: 4048757].
11. Li K, Evans PJ, Seitz WH, Jr., Li ZM. Carpal tunnel syndrome impairs sustained precision pinch performance. Clin Neurophysiol. 2015;126(1):194-201. doi: 10.1016/j.clinph.2014.05.004. [PubMed: 24877682]. [PubMed Central: PMC4234695].
12. Sibley PA, Mandel RJ. Atraumatic acute carpal tunnel syndrome in a patient taking dabigatran. Orthopedics. 2012;35(8):e1286-e1289. doi: 10.3928/01477447-20120725-37. [PubMed: 22868623].
13. Chadha P, Wordsworth M, Eckersley R. Spontaneous hematoma into the carpal tunnel and palmar aponeurosis. Eplasty. 2015;15:ic8. [PubMed: 25671059]. [PubMed Central: PMC4313669].
14. Komura S, Hirakawa A, Masuda T, Ito Y, Akiyama H. Recurrent atraumatic acute carpal tunnel syndrome due to hematoma caused by distal radioulnar joint arthritis duringanticoagulant treatment with apixaban. Arch Orthop Trauma Surg. 2017;137(8):1161-4. doi: 10.1007/s00402-017-2730-y. [PubMed: 28608274].
Tuncali D, Barutcu AY, Aslan G. Is surgical hemostasis really necessary in open carpal tunnel release? Plast Reconstr Surg. 2005;115(7):2160-1. doi: 10.1097/01.prs.0000165484.12750.d1. [PubMed: 15923892].
Orak MM, Gumustas SA, Onay T, Uludag S, Bulut G, Boru UT. Comparison of postoperative pain after open and endoscopic
17.
carpal tunnel release: A randomized controlled study. Indian J Orthop. 2016;50(1):65-9. doi: 10.4103/0019-5413.173509. [PubMed: 26955179]. [PubMed Central: PMC4759877].
Shibuya Y, Matsumoto G, Sasaki M, Sasaki K, Adachi K, Sekido M. A simple, novel technique for fixing Penrose drains in minor surgeries, with advantages for remote outpatient clinics: A retrospective comparison with conventional drain fixation in North Ibaraki, Japan. Rural Remote Health. 2017;17(4):4159. doi: 10.22605/RRH4159. [PubMed: 28978204].
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Issue | Vol 10 No 1 (2024) | |
Section | Research Articles | |
DOI | https://doi.org/10.18502/jost.v10i1.14964 | |
Keywords | ||
carpal tunnel syndrome penrose drain |
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