Do antibacterial skin sutures reduce surgical site infections after elective open abdominal surgery? - Study protocol of a prospective, randomized controlled single center trial

Matz, Daniel; Teuteberg, S; Wiencierz, Andrea; Soysal, Savas D.; Heizmann, Oleg

doi:10.1186/s13063-019-3492-3

Cited by 9 publications

(13 citation statements)

References 26 publications

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“…Although orthopedic surgeons have controlled and eradicated infections by including preventive use of antibiotics and strict aseptic practice, they still cannot completely eliminate the occurrence of infections. [19] Many studies [20][21][22] have shown that many factors contribute to the occurrence of SSIs after surgery, and the choice of suture is also one of them. [6,23] Recent laboratory and clinical studies have also revealed that can adhere to braided sutures and form a biofilm-like structure.…”

Section: Discussionmentioning

confidence: 99%

The role of triclosan-coated suture in preventing surgical infection: A meta-analysis

Liu

Chen

et al. 2023

Jt Dis Relat Surg

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Surgical site infection (SSI) is a severe postoperative adverse event that not only increases the cost of treatment, but also prolongs the recovery time and pain of patients. It usually occurs due to the destruction of bone tissue structure and implantation of internal fixation during orthopedic surgery. [1,2] All surgeries are classified into four categories according to the wound classification system: clean, clean/contaminated, contaminated, and dirty. [3] Hip and knee arthroplasty is a type of clean operation in orthopedics; that is, the surgical incision does not involve inflammatory areas, respiratory tract, digestive tract, and urogenital tract. [4] In general, after the strict aseptic operation and preventive use of antibiotics, the probability of postoperative infection is low. However, once an infection occurs, the consequences would be catastrophic. During surgical procedures, various species of germs have the potential to colonize not only the tissue in the surgical area, but also the sutures. [5,6] Objectives: In this meta-analysis, we aimed to compare the differences in surgical site infection (SSI) between triclosancoated and uncoated sutures after hip and knee arthroplasty. Patients and methods:We searched PubMed, Embase, and Cochrane databases for randomized-controlled studies (RCTs) comparing triclosan-coated sutures with uncoated sutures for the prevention of SSIs after hip and knee arthroplasty. Literature screening and data curation were performed according to inclusion and exclusion criteria and the risk of bias was assessed for included research using Cochrane Handbook criteria.Results: Three RCTs with a total of 2,689 cases were finally included, including 1,296 cases in the triclosan-coated suture group and 1,393 cases in the control group. The overall incidence of SSI was lower in the group with triclosan antimicrobial sutures (1.9%) than in the uncoated suture group (2.5%), but the difference was statistically significant (odds ratio=0.76, 95% confidence interval: [0.45-1.27], p=0.30). The differences in the results of the incidence of superficial SSI and deep SSI were not statistically significant (p>0.05). Conclusion:The application of triclosan antimicrobial sutures did not reduce the incidence of SSI after hip and knee arthroplasty compared to the controls, and it needs further high-quality RCT studies to be improved.

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Section: Discussionmentioning

confidence: 99%

The role of triclosan-coated suture in preventing surgical infection: A meta-analysis

Liu

Chen

et al. 2023

Jt Dis Relat Surg

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“…The primary source of surgical site infection is contamination of the wound and inadequate wound disinfection prior to surgical closure. The role of antimicrobial sutures in preventing surgical site infection remains critical to address antimicrobial resistant pathogens [11][12][13][14]. The material of the surgical suture participates in bacteria adhesion and formation biofilm on its surface and becomes resistant to conventional antimicrobial drugs [6].…”

Section: Introductionmentioning

confidence: 99%

Natural Cellulose Fibers for Surgical Suture Applications

et al. 2020

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Suture biomaterials are critical in wound repair by providing support to the healing of different tissues including vascular surgery, hemostasis, and plastic surgery. Important properties of a suture material include physical properties, handling characteristics, and biological response for successful performance. However, bacteria can bind to sutures and become a source of infection. For this reason, there is a need for new biomaterials for suture with antifouling properties. Here we report two types of cellulose fibers from coconut (Cocos nucifera) and sisal (Agave sisalana), which were purified with a chemical method, characterized, and tested in vitro and in vivo. According to SEM images, the cellulose fiber from coconut has a porous surface, and sisal has a uniform structure without internal spaces. It was found that the cellulose fiber from sisal has mechanical properties closer to silk fiber biomaterial using Ultimate Tensile Strength. When evaluating the cellulose fibers biodegradability, the cellulose from coconut showed a rapid weight loss compared to sisal. The antifouling test was negative, which demonstrated that neither possesses intrinsic microbicidal activity. Yet, a weak biofilm was formed on sisal cellulose fibers suggesting it possesses antifouling properties compared to cellulose from coconut. In vivo experiments using healthy mice demonstrated that the scarring and mechanical connection was like silk for both cellulose fibers. Overall, our results showed the potential use of cellulose fibers from vegetal for surgical sutures due to excellent mechanical properties, rapid degradation, and no bacterial adhesion.

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“…There is currently a growing demand for suture materials as surgical procedures are increasing in number and because material requirements differ for each procedure [168]. Work is underway to develop second-generation sutures displaying bioactive functionalities, i.e., antimicrobial sutures for preventing surgery-associated infections [169] or absorbable sutures. Microbial polymers have found a niche in this field due to their tensile properties, which help to resist tissue-induced stress, and because of their ease of functionalization.…”

Section: Sutures and Biological Gluesmentioning

confidence: 99%

From Residues to Added-Value Bacterial Biopolymers as Nanomaterials for Biomedical Applications

et al. 2021

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Bacterial biopolymers are naturally occurring materials comprising a wide range of molecules with diverse chemical structures that can be produced from renewable sources following the principles of the circular economy. Over the last decades, they have gained substantial interest in the biomedical field as drug nanocarriers, implantable material coatings, and tissue-regeneration scaffolds or membranes due to their inherent biocompatibility, biodegradability into nonhazardous disintegration products, and their mechanical properties, which are similar to those of human tissues. The present review focuses upon three technologically advanced bacterial biopolymers, namely, bacterial cellulose (BC), polyhydroxyalkanoates (PHA), and γ-polyglutamic acid (PGA), as models of different carbon-backbone structures (polysaccharides, polyesters, and polyamides) produced by bacteria that are suitable for biomedical applications in nanoscale systems. This selection models evidence of the wide versatility of microorganisms to generate biopolymers by diverse metabolic strategies. We highlight the suitability for applied sustainable bioprocesses for the production of BC, PHA, and PGA based on renewable carbon sources and the singularity of each process driven by bacterial machinery. The inherent properties of each polymer can be fine-tuned by means of chemical and biotechnological approaches, such as metabolic engineering and peptide functionalization, to further expand their structural diversity and their applicability as nanomaterials in biomedicine.

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Do antibacterial skin sutures reduce surgical site infections after elective open abdominal surgery? - Study protocol of a prospective, randomized controlled single center trial

Cited by 9 publications

References 26 publications

The role of triclosan-coated suture in preventing surgical infection: A meta-analysis

The role of triclosan-coated suture in preventing surgical infection: A meta-analysis

Natural Cellulose Fibers for Surgical Suture Applications

From Residues to Added-Value Bacterial Biopolymers as Nanomaterials for Biomedical Applications

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