A Study of the Efficacy of Antibacterial Sutures for Surgical Site Infection: A Retrospective Controlled Trial

Abstract

To reduce bacterial adherence to surgical sutures, triclosan-coated polyglactin 910 suture materials with antiseptic activity were developed. The aim of this study was to evaluate whether the incidence of surgical site infections can be reduced when triclosan-coated sutures are used. Until December 2009, we used conventional polyglactin 910 sutures (VICRYL, Ethicon) for the closure of the fascia in digestive tract surgery. Therefore, for the control group we retrospectively collected surveillance data for 1.5 years. In the control group, 611 patients underwent digestive tract surgery with VICRYL sutures. Beginning in July 2010, we used triclosan-coated polyglactin 910 sutures (VICRYL Plus, Ethicon, Tokyo, Japan) for the closure of the fascia in all digestive surgeries. So, we collected data for the study group from July 2010 until June 2011. In the study group, 467 patients underwent digestive tract surgery with triclosan-coated VICRYL Plus sutures. In the control group, 75 patients (12.2%) developed wound infections. In the study group, 31 patients (6.6%) developed wound infections, which was significantly lower. Emergency cases; laparoscopic cases, including some cholecystectomy and colectomy cases; American Society of Anesthesiologists classification; the use of immunosuppressive therapy; colostomy cases; wound classification; and suture material were identified as the risk factors for wound infections. In both groups, as the wound classification worsened, the wound infection rate increased. Triclosan-coated polyglactin 910 antimicrobial sutures lead to a significant decrease in the incidence of surgical site infections, especially in clean/contaminated cases.

Meta-analysis of the potential economic impact following introduction of absorbable antimicrobial sutures

“…Hoshino et al 31 Digestive tract surgery Galal and El-Hindawy 29 Multiple surgical wound types Takeno et al 52 Abdominal surgery…”

Triclosan coated sutures: an overview of safety and efficacy in reducing risk of surgical site infection

“…37 A recent paper on gastric cancer surgery via midline laparotomy also showed the reduction of SSI cases in abdominal wall closure. 38 Other prospective studies in digestive tract surgery, 39 breast cancer surgeries, 40 abdominal surgeries, 41 and cardiac surgeries (sternal site infections), 42 TCS was found to be effective in minimizing the risk of development of SSI post-surgery.…”

Controlled release drug delivery systems to improve post-operative pharmacotherapy

“…Oral, transdermal and injectable dosage forms are often used to administer these CR systems to prolong the delivery of drugs for one or a few days. In addition to dedicated drug delivery systems, medical devices also have been used, which are augmented with CR drug delivery functionality; examples of this include surgical sutures [8,9], wound dressing [10,11], hernia repair mesh [12,13], central lines and catheters [14,15], bone cements [16] and orthopaedic implants [17]. Common post-operative complications are now discussed alongside current options for pharmacotherapy including CR systems.…”

“…Recently, interest has increased around the CR of bioactives from surgical sutures to control post-operative infections [64]. The anti-microbial efficacy of triclosan-coated polyglactin 910 sutures (VICRYL ® Plus) to decrease the incidence of surgical site infection (SSI) was demonstrated against conventional VICRYL ® sutures in a retrospective controlled trial in patients undergoing abdominal surgeries [8]. But, the efficacy of surgical sutures coated with antibiotics to control SSI in wider post-surgical applications has been inconclusive.…”