Evaluation of the effect of triclosan coated sutures in the prevention of surgical site infections in a Spanish hospital setting: A prospective, observational study

Abstract

Summary Background Surgical site infections (SSIs) are one of the most frequently reported types of hospital-acquired infection and are associated with substantial clinical and economic burden. Aim To assess the incidence of SSIs and analyze contributing risk factors in a real-world Spanish hospital setting before and after the implementation of triclosan-coated sutures (TCS). Methods A prospective, observational study was conducted at Hospital Clínico Universitario de Santiago de Compostela, Spain. Enrolled patients underwent surgery in the following specialties: general surgery, urology, neurosurgery, gynaecology, and traumatology. The primary outcome of the study was SSI incidence, assessed at a 30-day follow-up. Secondary outcomes were length of hospital stay, and readmission, reintervention, and mortality rates, also at 30 days. Findings 5,081 patients were included in the study, of which 2,591 were treated using non-coated sutures (NCS) and 2,490 using TCS. After adjusting for potential confounders, TCS significantly reduced SSI rate by 36%, compared with NCS (odds ratio [OR]: 0.64; 95% confidence interval [CI]: 0.48–0.85; P <0.003). When stratified by wound classification, a statistically significant reduction in SSI incidence, in favour of TCS use, was observed for Class IV (dirty) wounds (35.6% versus 22.7% for NCS and TCS, respectively; OR: 0.53; 95% CI: 0.31–0.90). Conclusion The use of TCS reduced SSI risk when compared with NCS. This reduction was significant for Class IV wounds, providing evidence that supports the use of TCS for this type of wound.

Evaluation of Triclosan coated suture in obstetrical surgery: A prospective randomized controlled study (NCT05330650)

“…In contrast, others have failed to demonstrate protective role of TCS use. These discrepancies may be explained by differences in study population, type of procedure, or the layers where the sutures were applied [ 3 ].…”

“…SSIs results in substantial clinical and economic burden. In fact, prolonged hospital stay, increasing rate of readmission and reintervention, reduction in measures quality of life and high morality are associated with SSIs [ 3 ].…”

“…A recent metanalysis including 11 957 patients across 25 randomized controlled trials (RCTs) showed that TCS was more effective in reducing SSI risk by 27 percent compared to non-coated suture [ 1 ]. Data from twelve other metanalysis concluded that TCS reduced SSI risk by 24 to 39% [ 3 ].…”

Design of biocompatible polylactic acid–polyethylene glycol combination for manufacturing biodegradable staplers

“…For example, suturing non‐linear wounds require special expertise, and the outcome is largely determined by the surgeon's expertise. It is still possible to get an infection despite the sutures' sterility since the spaces allow bacteria to colonize 10,11 . Comparatively, adhesive strips are ineffective in wet or tensioned areas and have the lowest tensile strength.…”

“…It is still possible to get an infection despite the sutures' sterility since the spaces allow bacteria to colonize. 10,11 Comparatively, adhesive strips are ineffective in wet or tensioned areas and have the lowest tensile strength. For minor lacerations, strips are usually recommended as reinforcement for surgical staples and sutures.…”