Effect of Triclosan-Coated Suture and Antibiotic Prophylaxis on Infection and Recurrence after Karydakis Flap Repair for Pilonidal Disease: A Randomized Parallel-Arm Double-Blinded Clinical Trial

Karip, Aziz Bora; Çelik, Kafkas; Aydin, Timucin; Yazicilar, Hanife Aydin; İşcan, Yalın; Ağalar, Canan; Memışoğlu, Kemal

doi:10.1089/sur.2015.207

Cited by 13 publications

(15 citation statements)

References 23 publications

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“…Study characteristics are summarised in table 1. Twenty-five RCTs were included in this review involving 11 957 patients 2 7 11 33 34 38–57. There were 6008 patients randomised to triclosan-coated sutures and 5949 patients to standard sutures.…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies were multicentre, with the remainder single-centre studies (n=17). Vicryl was compared with Vicryl Plus in 12 studies,11 34 39–41 43 46–49 54 56 3 studies compared PDS versus PDS Plus,7 38 55 1 study compared PDS II with PDS II Plus,44 2 study compared Monocryl against Monocryl Plus,45 57 1 compared Chinese silk with Vicryl Plus,53 4 studies compared Vicryl and Monocryl versus Vicryl Plus and Monocryl Plus33 50–52 and 2 studies compared Vicryl and PDS versus Vicryl Plus and PDS Plus 2 42…”

Section: Resultsmentioning

confidence: 99%

“…To define SSI, the centre for disease control (CDC) criteria were used by 18 studies,2 7 11 33 34 41–44 48 50–57 clinical diagnosis or wound cultures was used by 3 studies studies,39 45 49 and 4 did not provide explicit definitions 38 40 46 47. Seventeen studies used a follow-up duration of 30 days or 1 month or 4 weeks,2 7 11 33 34 38 41–43 46 49 51 53–57 3 for 6 weeks,48 50 52 2 for 2 weeks,44 45 1 for 80 days40, 1 until discharge47 and 1 study did not specify a follow-up regime 39.…”

Section: Resultsmentioning

confidence: 99%

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The use of triclosan-coated sutures to prevent surgical site infections: a systematic review and meta-analysis of the literature

et al. 2019

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Introduction and objectivesSurgical site infections (SSIs) represent a common and serious complication of all surgical interventions. Microorganisms are able to colonise sutures that are implanted in the skin, which is a causative factor of SSIs. Triclosan-coated sutures are antibacterial sutures aimed at reducing SSIs. Our objective is to update the existing literature by systematically reviewing available evidence to assess the effectiveness of triclosan-coated sutures in the prevention of SSIs.MethodsA systematic review of EMBASE, MEDLINE, AMED (Allied and complementary medicine database) and CENTRAL was performed to identify full text randomised controlled trials (RCTs) on 31 May 2019.InterventionTriclosan-coated sutures versus non-triclosan-coated sutures.Primary outcomeOur primary outcome was the development of SSIs at 30 days postoperatively. A meta-analysis was performed using a fixed-effects model.ResultsTwenty-five RCTs were included involving 11 957 participants. Triclosan-coated sutures were used in 6008 participants and non triclosan-coated sutures were used in 5949. Triclosan-coated sutures significantly reduced the risk of SSIs at 30 days (relative risk 0.73, 95% CI 0.65 to 0.82). Further sensitivity analysis demonstrated that triclosan-coated sutures significantly reduced the risk of SSIs in both clean and contaminated surgery.ConclusionTriclosan-coated sutures have been shown to significantly reduced the risk of SSIs when compared with standard sutures. This is in agreement with previous work in this area. This study represented the largest review to date in this area. This moderate quality evidence recommends the use of triclosan-coated sutures in order to reduce the risk of SSIs particularly in clean and contaminated surgical procedures.PROSPERO registration numberCRD42014014856

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The use of triclosan-coated sutures to prevent surgical site infections: a systematic review and meta-analysis of the literature

et al. 2019

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“…In a randomised parallel-arm double-blinded trial comparing antimicrobial prophylaxis vs no prophylaxis in patients undergoing Karydakis flap reconstruction, the no prophylaxis arm was terminated prematurely because of a significantly higher rate of infectious complications. 38 In addition, this trial demonstrated no significant benefit from the use of triclosan-coated sutures. To date, there has been little level 1 evidence to recommend antimicrobial prophylaxis for pilonidal excision with primary closure, although this may not be applicable to flap reconstruction techniques.…”

Section: Antimicrobialsmentioning

confidence: 78%

“…Although antimicrobial prophylaxis was not associated with improved rates of SSI and wound healing in excision with primary closure in the aforementioned systematic review, this lack of benefit may not apply to flap reconstruction. In a randomised parallel‐arm double‐blinded trial comparing antimicrobial prophylaxis vs no prophylaxis in patients undergoing Karydakis flap reconstruction, the no prophylaxis arm was terminated prematurely because of a significantly higher rate of infectious complications . In addition, this trial demonstrated no significant benefit from the use of triclosan‐coated sutures.…”

Section: Adjuncts To Surgerymentioning

confidence: 99%

Management of sacrococcygeal pilonidal sinus disease

Harries

Alqallaf

Torkington

et al. 2018

International Wound Journal

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The ideal treatment for patients who suffer from pilonidal sinus disease should lead to a cure with a rapid recovery period allowing a return to normal daily activities, with a low level of associated morbidity. A variety of different surgical techniques have been described for the primary treatment of pilonidal sinus disease and current practice remains variable and contentious. Whilst some management options have improved outcomes for some patients, the complications of surgery, particularly related to wound healing, often remain worse than the primary disease. This clinical review aims to provide an update on the management options to guide clinicians involved in the care of patients who suffer from sacrococcygeal pilonidal sinus disease.

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

Leaper

Edmiston

Holy

2017

British Journal of Surgery

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Background: Despite several randomized trials, systematic reviews and meta-analyses that have demonstrated the effectiveness of antimicrobial (triclosan-coated or -impregnated) sutures (TCS), the clinical and economic impact of using these sutures compared with conventional non-antimicrobial-coated absorbable sutures (NCS) remains poorly documented.Methods: An independent systematic review and meta-analysis of all published evidence from January 2005 to September 2016 comparing TCS with NCS was conducted. Surgical-site infection (SSI) was the primary outcome. The results of the meta-analysis were used in a decision-tree deterministic and stochastic cost model, using the National Health Service (NHS England)-based cost of inpatient admissions for infections and differential costs of TCS versus NCS.Results: Thirty-four studies were included in the final assessment from an initial 163 identified citations; 20 of 34 studies were randomized, and 17 of 34 reported blinding of physicians and assessors. Using a random-effects model, the odds ratio for SSI in the TCS compared with NCS control groups was statistically significant (odds ratio 0⋅61, 95 per cent c.i. 0⋅52 to 0⋅73; P < 0⋅001). There was significant heterogeneity (I 2 = 49 per cent). Using random-effects event estimates of SSI for TCS and NCS for each individual wound type, the mean savings per surgical procedure from using antimicrobial sutures were significant: £91⋅25 (90 per cent c.i. 49⋅62 to 142⋅76) (€105⋅09 (57⋅15 to 164⋅41); exchange rate 15 November 2016) across all wound types. Conclusion:The reviewed literature suggested that antimicrobial sutures may result in significant savings across various surgical wound types.

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Effect of Triclosan-Coated Suture and Antibiotic Prophylaxis on Infection and Recurrence after Karydakis Flap Repair for Pilonidal Disease: A Randomized Parallel-Arm Double-Blinded Clinical Trial

Cited by 13 publications

References 23 publications

The use of triclosan-coated sutures to prevent surgical site infections: a systematic review and meta-analysis of the literature

The use of triclosan-coated sutures to prevent surgical site infections: a systematic review and meta-analysis of the literature

Management of sacrococcygeal pilonidal sinus disease

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

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