Surgical Dressings After Endoscopic Carpal Tunnel Release
- Conditions
- Carpal Tunnel Syndrome
- Interventions
- Other: BandaidOther: Conventional bulky soft tissue dressing
- Registration Number
- NCT04070924
- Lead Sponsor
- Chris Grandizio
- Brief Summary
Carpal tunnel syndrome (CTS) is the most common compressive neuropathy in the upper extremity. While carpal tunnel release (CTR), both open (OCTR) and endoscopic (ECTR), is safe and effective, there are questions regarding the use of postoperative dressings after surgery. It is not currently known if dressing choices influence post-operative pain, function or patient satisfaction after ECTR. A less cumbersome dressing (bandaid) may allow patients to perform daily tasks with more ease after surgery. The purpose of this investigation is to compare postoperative pain scores and patient satisfaction after ECTR for patients treated with conventional post-operative bulky soft tissue dressings versus those treated with a bandaid after surgery. The hypothesis is that patients using a bandaid after surgery will have an easier time with functional tasks after surgery and that pain scores will not significantly differ between the two groups. Furthermore, this study aims to determine if there are differences in patient satisfaction, functional outcomes, complications, and unscheduled healthcare contact between these two groups. This will be a randomized, controlled investigation.
- Detailed Description
Carpal tunnel syndrome (CTS) is the most common compressive neuropathy in the upper extremity. While carpal tunnel release (CTR), both open (OCTR) and endoscopic (ECTR), is safe and effective, there are questions regarding the use of postoperative dressings after surgery. With recent attention to the opioid epidemic, there have been increasing efforts to reduce narcotic usage postoperatively while still controlling expected postoperative pain. Recent authors have found that many patients, particularly older patients, do not require any opioid analgesia after CTR with 47% of men and 36% of women consuming no narcotics after CTR (CHAPMAN). Furthermore, while splints have historically been used after surgery, their need has recently been questioned (LOGLI). It is not currently known if dressing choices influence post-operative pain, function or patient satisfaction after ECTR. A less cumbersome dressing (bandaid) may allow patients to perform daily tasks with more ease after surgery.
The purpose of this investigation is to compare postoperative pain scores and patient satisfaction after ECTR for patients treated with conventional post-operative bulky soft tissue dressings versus those treated with a bandaid after surgery. The hypothesis is that patients using a bandaid after surgery will have an easier time with functional tasks after surgery and that pain scores will not significantly differ between the two groups. Furthermore, this study aims to determine if there are differences in patient satisfaction, functional outcomes, complications, and unscheduled healthcare contact between these two groups. This will be a randomized, controlled investigation.
Recruitment & Eligibility
- Status
- WITHDRAWN
- Sex
- All
- Target Recruitment
- Not specified
- Patients 18 years of age or older
- Patients undergoing primary, elective, unilateral ECTR under monitored anesthesia care with local anesthesia.
- Patients undergoing ECTR as part of a worker's compensation case
- Patients currently incarcerated
- Subject who cannot read and speak English
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Bandaid post-operative dressing Bandaid 1. Intraoperative: MAC-Local Anesthesia; Local anesthetic mixture will be distributed in both the subcutaneous tissue and within the carpal canal 2. Postoperative: Non-opioid medications only; Bandaid over incision (Patient given an edema glove to wear starting post-operative day 1; Dressing change be changed post-operative day 2 and as needed after that) Conventional post-operative bulky soft tissue dressing Conventional bulky soft tissue dressing 1. Intraoperative: MAC-Local Anesthesia; Local anesthetic mixture will be distributed in both the subcutaneous tissue and within the carpal canal 2. Postoperative: Non-opioid medications only; Conventional post-operative bulky soft tissue dressing (Xeroform, 4x4s, Webril, Ace Wrap; Worn until first postoperative visit)
- Primary Outcome Measures
Name Time Method Visual Analog Scale Pain Score 0-12 months best 0-10 worst; continuous scale to measure current pain level
- Secondary Outcome Measures
Name Time Method Satisfaction with the dressing 0-12 months 11 point Likert scale; worst 0-10 best
PROMIS Upper Extremity 0-12 months worst 0-100 best; measures physical function of upper extremities
QuickDASH 0-12 months best 0-100 worst; functional outcome score for disabilities of the arm, shoulder, and hand
Satisfaction with overall outcome 0-12 months 11 point Likert scale; worst 0-10 best
PROMIS Self-Efficacy Manage Symptoms 0-12 months best 0-100 worst; measures a patient's ability to cope with their symptoms related to the procedure
morphine equivalents 0-12 months morphine equivalents consumed for post-operative pain control
PROMIS Pain Interference 0-12 months best 0-100 worst; measures the effects of a patient's pain on their daily activities and lifestyle
number of participants with complications 0-12 months complications after surgery including infection and delayed healing
Boston Carpal Tunnel Questionnaire 0-12 months ranges from 1 to 5, with a higher score indicating greater disability; -specific measure of self-reported symptom severity and functional status
number of participants with unscheduled healthcare contact 0-12 months unscheduled healthcare contact includes patient calls/messages, emergency room visits, or scheduled clinic visits
Satisfaction postoperative pain control 0-12 months 11 point Likert scale; worst 0-10 best
Grip Strength Measurement 0-12 months Using Jamar Hand Dynamometer, in kilograms ranging from worst 0-90 best