Efficiency of Antibacterial Suture Material in Cardiac Surgery: A Double-Blind Randomized Prospective Study

Işık, Işıl; Şelimen, Deniz; Şenay, Şahin; Alhan, Cem

doi:10.1532/hsf98.20111106

Cited by 31 publications

(38 citation statements)

References 23 publications

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“…Double‐blind randomized study of triclosan‐coated sutures on SSI in cardiac surgery patients reported that 2.4% and 3.5% patients were recorded for the incidence of sternal infections and leg wound infections respectively, which is comparatively less than the infection rate reported following the use of conventional sutures . Further, randomized controlled trial in colorectal surgery with 410 participants involving 206 patients using triclosan‐coated sutures and 204 patients with conventional suture showed reduced incidence of wound infection at the surgical site following the use of triclosan‐coated suture .…”

Section: Recent and Emerging Trendsmentioning

confidence: 99%

Suture materials — Current and emerging trends

Christopher

Sethu

Nayak

et al. 2016

J Biomedical Materials Res

136

105

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Surgical sutures are used to facilitate closure and healing of surgical-or trauma-induced wounds by upholding tissues together to facilitate healing process. There is a wide range of suture materials for medical purpose and the main types include absorbable and nonabsorbable. Recently, there is a growth in the development of classes of suture materials based on their properties and capabilities to improve tissue approximation and wound closure. This review outlines and discusses the current and emerging trends in suture technology including knotless barbed sutures, antimicrobial sutures, bio-active sutures such as drug-eluting and stem cells seeded sutures, and smart sutures including elastic, and electronic sutures. These newer strategies expand the versatility of sutures from being used as just a physical entity approximating opposing tissues to a more biologically active component enabling delivery of drugs and cells to the desired site with immense application potential in both therapeutics and diagnostics.

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Section: Recent and Emerging Trendsmentioning

confidence: 99%

Suture materials — Current and emerging trends

Christopher

Sethu

Nayak

et al. 2016

J Biomedical Materials Res

136

105

View full text Add to dashboard Cite

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“…RCTs have been conducted to investigate its effect on SSI in various surgical procedures and with different types of suture. Several meta‐analyses have been published showing different results, but also a wide variety in study and data selection ( Table ). None of these previously published meta‐analyses used meta‐regression to substantiate subgroup effects and assess generalizability of the overall effect across subgroups.…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis and trial sequential analysis of triclosan-coated sutures for the prevention of surgical-site infection

Jonge

Atema

Solomkin

et al. 2017

British Journal of Surgery

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Background: Triclosan-coated sutures (TCS) were developed to reduce the risk of surgical-site infection (SSI). Level 1A evidence of effectiveness has been presented in various recent meta-analyses, yet well designed RCTs have not been able to reproduce these favourable results. The aim of this study was to evaluate all available evidence critically with comprehensive analysis to seek a more reliable answer regarding the effectiveness of TCS in the prevention of SSI.Methods: PubMed, MEDLINE, Embase and Cochrane Library databases were searched from 1990 to November 2015 for RCTs that compared TCS with sutures that were exactly the same, but uncoated, in the prevention of SSI. Pooled relative risks (RRs) with corresponding 95 per cent confidence intervals were estimated using a random-effects model. Metaregression was used to substantiate subgroup effects, trial sequential analysis was employed to assess the risk of random error, and quality of evidence was determined using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Conclusion: GRADE assessment shows moderate-quality evidence that TCS are effective in reducing SSI. Trial sequential analysis indicates that the effect was robust, and additional data are unlikely to alter the summary effect.

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“…[14] found no difference in sternal wound infection in a retrospective study and in a randomized study, Isik et al . [9] found no difference in either sternal wound or leg-wound infections. In a recent systematic review and meta-analysis of randomized trials with triclosan-coated sutures, Chang et al .…”

Section: Discussionmentioning

confidence: 99%

Triclosan-coated sutures reduce surgical site infection after open vein harvesting in coronary artery bypass grafting patients: a randomized controlled trial†

Thimour-Bergström

Roman-Emanuel

Scherstén

et al. 2013

European Journal of Cardio-Thoracic Surgery

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OBJECTIVESThe incidence of surgical site infection (SSI) after open vein harvesting in coronary artery bypass grafting (CABG) patients ranges in different studies between 2 and 20%. Triclosan is an antibacterial substance that reduces the growth of bacteria by inhibiting fatty acid synthesis. We hypothesized that wound closure with triclosan-coated sutures would reduce SSI after open vein harvesting.METHODSAn investigator-initiated prospective randomized double-blind single-centre study was performed with 374 patients, randomized to subcutaneous and intracutaneous leg-wound closure with either triclosan-coated sutures (Vicryl Plus® and Monocryl Plus®, Ethicon, Somerville, NJ, USA) (n = 184) or identical sutures without triclosan (n = 190) from the same manufacturer. All patients were followed up after 30 days (clinical visit) and 60 days (telephone interview). Primary endpoint was SSI within 60 days after surgery according to the definition of Center for Disease Control. Predefined secondary endpoints included culture-proven and antibiotic-treated SSI.RESULTSThe primary endpoint occurred in 23 patients (12.5%) with triclosan-coated sutures and in 38 patients (20.0%) in the group without triclosan (P = 0.0497, risk ratio 0.63, (95% confidence interval 0.39–1.00). Corresponding figures for culture-proven infections were 7.6 vs 12.1%, (P = 0.15), and for antibiotic-treated infections, 10.9 vs 18.4%, (P = 0.039). Staphylococcus aureus and coagulase-negative staphylococci were the most common pathogens in both groups. Insulin-treated diabetes and vein-harvesting time were associated with SSI after vein harvesting.CONCLUSIONSLeg-wound closure with triclosan-coated sutures in CABG patients reduces SSIs after open vein harvesting. (ClinicalTrials.gov number NCT01212315).

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Efficiency of Antibacterial Suture Material in Cardiac Surgery: A Double-Blind Randomized Prospective Study

Abstract: Both noncoated and triclosan-coated suture materials are safe. Larger studies may be needed to show the benefit and cost-effectiveness, if any, of triclosan-coated materials over noncoated materials.

Cited by 31 publications

References 23 publications

Suture materials — Current and emerging trends

Suture materials — Current and emerging trends

Meta-analysis and trial sequential analysis of triclosan-coated sutures for the prevention of surgical-site infection

Triclosan-coated sutures reduce surgical site infection after open vein harvesting in coronary artery bypass grafting patients: a randomized controlled trial†

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