Do antibacterial-coated sutures reduce wound infection in head and neck cancer reconstruction?

Chen, Shih-Yi; Chen, Tim‐Mo; Dai, Niann‐Tzyy; Fu, Ju-Peng; Chang, Stephen S.; Deng, Shou-Cheng; Chen, Shyi-Gen

doi:10.1016/j.ejso.2011.01.015

Cited by 42 publications

(55 citation statements)

References 24 publications

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“…Similarly, a reduced rate of SSI was found in patients undergoing hepatobiliary surgery utilizing a transverse abdominal incision (9.2% with polidioxanone alone versus 4.3% with triclosan-coated polyglactin 910) [25]. However, other studies exploring antibacterial sutures in other surgical settings have not shown any significant difference [26,27], suggesting these effects may be to some extent procedure-specific.…”

Section: Figmentioning

confidence: 80%

Bacterial Biofilms on Implanted Suture Material Are a Cause of Surgical Site Infection

Kathju

Nistico

Tower

et al. 2014

Surgical Infections

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Background: Surgical site infection (SSI) has been estimated to occur in up to 5% of all procedures, accounting for up to 0.5% of all hospital costs. Bacterial biofilms residing on implanted foreign bodies have been implicated as contributing or causative factors in a wide variety of infectious scenarios, but little consideration has been given to the potential for implanted, submerged suture material to act as a host for biofilm and thus serve as a nidus of infection. Methods: We report a series of 15 patients who underwent open Roux-en-Y gastric bypass (with musculofascial closure with permanent, multifilament sutures) who developed longstanding and refractory SSIs in the abdominal wall. Explanted suture material at subsequent exploration was examined for biofilm with confocal laser-scanning microscopy (CLSM) and fluorescence in situ hybridization (FISH). Results: All 15 patients at re-exploration were found to have gross evidence of a ''slimy'' matrix or dense reactive granulation tissue localized to the implanted sutures. Confocal laser-scanning microscopy revealed abundant biofilm present on all sutures examined; FISH was able to identify the presence of specific pathogens in the biofilm. Complete removal of the foreign bodies (and attendant biofilms) resulted in all cases in cure of the SSI. Conclusion: Bacterial biofilms on implanted suture material can manifest as persistent surgical site infections that require complete removal of the underlying foreign body substrata for resolution.

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Section: Figmentioning

confidence: 80%

Bacterial Biofilms on Implanted Suture Material Are a Cause of Surgical Site Infection

Kathju

Nistico

Tower

et al. 2014

Surgical Infections

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“…These infections accompany devices such as orthopedic implants [2], catheters [3], mechanical heart valves [1], pacemakers [1,4], sutures [5,6], ventricular shunts [7], and stents [8]. One of the most practical strategies undertaken over the last 30 years to prevent these infections has been to develop biomaterial device coatings that release antimicrobial compounds into the surrounding tissues and fluids of a patient [9–11].…”

Section: Introductionmentioning

confidence: 99%

“…These coatings are referred to as active release coatings. To date, only a handful of these coatings have been put into clinical use [5,10,12–23]. Clinical studies have shown that these coatings have had minimal to no success in reducing rates of infection in patients [5,10,12–24].…”

Section: Introductionmentioning

confidence: 99%

In vivo efficacy of a silicone‒cationic steroid antimicrobial coating to prevent implant-related infection

et al. 2012

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Active release antimicrobial coatings for medical devices have been developed to prevent and treat biofilm implant-related infections. To date, only a handful of coatings have been put into clinical use, with limited success. In this study, a novel antimicrobial compound was incorporated into a silicone (polydimethylsiloxane or PDMS) polymer to develop a novel active release coating that addressed several limitations of current device coatings. The efficacy of this coating was optimized using an in vitro flow cells system, then translated to an animal model of a simulated Type IIIB open fracture wherein well-established biofilms were used as initial inocula. Results indicated that the novel coating was able to prevent infection in 100% (9/9) of animals that were treated with biofilms and the novel coating (treatment group). In contrast, 100% (9/9) of animals that were inoculated with biofilms and not treated with the coating (positive control), did develop infection. Nine animals were used as negative controls, i.e., those that were not treated with biofilms, and showed a rate of infection of 11% (1/9). Eight animals were treated with the novel coating only to determine its effect on host tissue. Results indicated that the novel active release coating may have significant promise for future application to prevent biofilm implant-related infections in patients.

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“…To date, few active release coatings on medical devices have been approved for use in patients 6–17. Clinical studies that have been performed with these approved coatings have had variable success.…”

Section: Introductionmentioning

confidence: 99%

Characterization of a novel active release coating to prevent biofilm implant‐related infections

et al. 2013

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Biofilm implant-related infections cost the US healthcare system billions of dollars each year. For several decades, device coatings have been developed that actively release antimicrobial compounds in an attempt to prevent these infections from developing. To date, few coatings have been put into clinical use. These have shown limited to no efficacy in clinical trials. Recent data have shown the in vitro and in vivo efficacy of a novel active release coating that may address the limitations of coatings that are used clinically. In this study, the novel active release coating was characterized to gain an understanding of the effects of combining an antimicrobial additive, cationic steroid antimicrobial-13 (CSA-13), to a medical grade polydimethylsiloxane (PDMS) material. Results indicated that the addition of CSA-13 did influence the physical properties of the PDMS, but not with adverse effects to the desired material properties. Furthermore, there was no indication of chemical reactivity. It was shown that CSA-13 was uniformly dispersed as small particles throughout the PDMS matrix. These particles were able to dissolve and elute out of the PDMS within a 30-day period. The results of this work suggested that the PDMS with CSA-13 was thermally, chemically and physically stable when used as a device coating to treat local infection and/or prevent biofilm implant-related infections from developing.

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Do antibacterial-coated sutures reduce wound infection in head and neck cancer reconstruction?

Cited by 42 publications

References 24 publications

Bacterial Biofilms on Implanted Suture Material Are a Cause of Surgical Site Infection

Bacterial Biofilms on Implanted Suture Material Are a Cause of Surgical Site Infection

In vivo efficacy of a silicone‒cationic steroid antimicrobial coating to prevent implant-related infection

Characterization of a novel active release coating to prevent biofilm implant‐related infections

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