Brief Article
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Orthop. Oct 18, 2013; 4(4): 299-302
Published online Oct 18, 2013. doi: 10.5312/wjo.v4.i4.299
Should aspirin be stopped before carpal tunnel surgery? A prospective study
Stefania Brunetti, Gianfranco John Petri, Stefano Lucchina, Guido Garavaglia, Cesare Fusetti
Stefania Brunetti, Gianfranco John Petri, Stefano Lucchina, Guido Garavaglia, Cesare Fusetti, Hand Surgery Unit, Department of Orthopaedics and Trauma Surgery, Ospedale Regionale Bellinzona e Valli, 6500 Bellinzona, Switzerland
Author contributions: Authors contributed equally to this manuscript.
Correspondence to: Dr. Stefania Brunetti, Hand Surgery Unit, Department of Orthopaedics and Trauma Surgery, Ospedale Regionale Bellinzona e Valli, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland. 9531@fastwebnet.it
Telephone: +41-91-8118921 Fax: +41-91-8119210
Received: December 4, 2012
Revised: April 3, 2013
Accepted: July 4, 2013
Published online: October 18, 2013
Processing time: 328 Days and 4 Hours
Abstract

AIM: To determine whether patients taking aspirin during carpal tunnel release had an increase of complications.

METHODS: Between January 2008 and January 2010, 150 patients underwent standard open carpal tunnel release (CTR) under intravenous regional anaesthesia. They were divided into three groups: groups 1 and 2 were made of 50 patients each, on aspirin 100 mg/d for at least a year. In group 1 the aspirin was never stopped. In group 2 it was stopped at least 5 d before surgery and resumed 3 d after. Group 3 acted as a control, with 50 patients who did not take aspirin. The incidence of clinically significant per- or post-operative complications was recorded and divided into local and cardio-cerebro-vascular complications. Local complications were then divided into minor and major according to Page and Stern. Local haematomas were assessed at 2 d (before resuming aspirin in group 2) and 14 d (after resuming aspirin in group 2) postoperatively. Patients were reviewed at 2, 14 and 90 d after surgery.

RESULTS: There was no significant difference in the incidence of complications in the three groups. A total of 3 complications (2 major and 1 minor) and 27 visible haematomas were recorded. Two major complications were observed respectively in group 1 (non stop aspirin) and in group 3 (never antiaggregated). The minor complication, observed in one patient of group 2 (stop aspirin), consisted of a wound dehiscence, which only led to delayed healing. All haematomas were observed in the first 48 h, no haematoma lasted for more than 2 wk and all resolved spontaneously. A major haematoma (score > 20 cm2) was observed in 8 patients. A minor haematoma (score < 20 cm2) was recorded in 19 patients. All patients at 90 d after surgery were satisfied with the result in terms of relief of their preoperative symptoms. Major and minor haematomas did not impair hand function or require any specific therapy.

CONCLUSION: Our study demonstrates that continuation of aspirin did not increase the risk of complications. It is unnecessary to stop aspirin before CTR with good surgical techniques.

Keywords: Carpal tunnel syndrome; Aspirin; Antiaggregation therapy; Hand surgery; Carpal tunnel release

Core tip: Our study demonstrates that continuation of aspirin did not increase the risk of local or general complications. Continuation of aspirin did not influence the subjective scar assessment. It is concluded that it is unnecessary to stop aspirin before carpal tunnel release when good meticulous surgical techniques are used.