The effect of triclosan-coated sutures on the rate of surgical site infection after hip and knee arthroplasty: a double-blind randomized controlled trial of 2546 patients

Abstract

This trial provided no evidence that the use of triclosan-coated sutures at THA and TKA leads to a reduction in the rate of SSI. Cite this article: Bone Joint J 2018;100-B:296-302.

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

“…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.…”

“…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…”

“…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.…”

“…Performing robust methodological appraisal of conference abstracts is not possible, they do not permit thorough risk of bias assessments, and as they have not undergone the formal journal peer-review process, they represent a potentially biassed and unreliable source of data. Since this review, a number of large, high-quality RCTs have been produced 33 34. Of note, a recent RCT of 2546 patients found that triclosan-coated sutures did not reduce the incidence of SSIs; a finding in contrast to the previous systematic review 32 34.…”

“…Since this review, a number of large, high-quality RCTs have been produced 33 34. Of note, a recent RCT of 2546 patients found that triclosan-coated sutures did not reduce the incidence of SSIs; a finding in contrast to the previous systematic review 32 34. This represents a substantial increase in the number of patients available for meta-analysis since the last review.…”