Elin ekstensör tendon onarımlarında kullanılan sütür materyallerinin reoperasyonlar ile ilişkisi

Amaç: Çalışmamızın amacı, elde ekstensör tendon onarımlarında kullanılan emilebilen ve emilemeyen sütür materyallerinin sütür reaksiyonu-irritasyonu ile ilişkili reoperasyonlar açısından karşılaştırılmasıdır. Gereç ve Yöntem: Çalışmamızda elde akut ekstensör tendon kesisi nedeniyle tendon onarımı yapılan hastalar retrospektif olarak değerlendirildi. Çalışma kriterlerine uyan hastalar, kullanılan sütür materyaline göre absorbabl sütür (AS) (polidiakson) ve nonabsorbabl sütür (NAS) (polipropilen) olarak iki gruba ayrıldı. Her iki grup yaş, cinsiyet, taraf ve sütür reaksiyonu ilişkili reoperasyon açısından karşılaştırıldı. Ayrıca her iki grupta tamir edilen tendonlar ve tamir bölgeleri değerlendirildi. Sütür reaksiyonu gelişen olguların, tamir edilen tendon ve tamir bölgesine göre dağılımı değerlendirildi. Bulgular: Çalışmada 172 hastanın 250 ekstensör tendon tamiri değerlendirildi. Hastaların, 103(%59.9)’ü NAS, 69(%40.1)’u AS grubunda yer aldı. Her iki grup yaş, cinsiyet ve taraf açısından benzerdi. Sütür reaksiyonu sebepli reoperasyon uygulanan toplam 31 olgunun 29(%93.5)’unda NAS, 2(%6.5)’sinde AS kullanılmıştı. Sütür reaksiyonu gelişen olguların % 74.2’sinin Zon 5 ve 6’da yer aldığı ve sıklıkla 2 ve 3. parmak ekstensör tendon onarımlarından sonra geliştiği tespit edildi. Sonuç: Çalışmamızda ekstensör tendon onarımlarında NAS (polipropilen) kullanımının sütür reaksiyonu nedeniyle reoperasyon sayısını arttırdığını tespit ettik. Dolayısıyla yumuşak doku desteği açısından fleksör bölgeye göre zayıf olan el dorsalindeki ekstensör tendon onarımlarında AS ile onarımın daha uygun olduğunu düşünmekteyiz.

Anahtar Kelimeler:

Ekstensör tendon, tendon onarımı, sütür reaksiyonu

Relationship between the suture materials used in extensor tendon injuries and reoperations

Purpose: The aim of our study was to compare the absorbable and non-absorbable suture materials used in hand extensor tendon repairs in terms of reoperations related to suture reaction-irritation. Materials and Methods: Patients who admitted to our institute with extensor tendon injury of the hand and underwent surgical repair were evaluated retrospectively. Patients who met the inclusion criteria were divided into two groups according to the suture materials as absorbable suture (AS) (polydioxanone) group and non-absorbable suture (NAS) (polypropylene) group. Age, gender, side, and necessity of suture reaction related surgery were compared between groups. Repaired tendons and injury levels were enrolled for both groups. Cases with reoperation due to the suture reactions were assessed. Results: There were 250 tendons of 172 patients met the inclusion criteria. One hundred and three (59.9%) patients were in NAS group and 69 (40.1%) were in AS group. Distribution of age, gender, and side were similar in both groups. There were 31 cases required suture related reoperation during follow-up. 29 (93.5 %) patients were in NAS group and 2 (%6.5) were in AS group. %74.2 of the cases were seen at zone 5 and 6 level, and frequently after the repair of extensor tendons of 2nd and 3rd digits. Conclusion: We have found that NAS (polypropylene) suture use for extensor tendon repair increased the suture related reoperation risk. Hence, we thought that AS use for extensor tendon repair can be more appropriate since the soft tissue coverage is relatively weaker than the flexor site.

Keywords:

Extensor tendon, Tendon repair, Suture reactions,

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