The Efficacy of Antimicrobial-Coated Sutures for Preventing Incisional Surgical Site Infections in Digestive Surgery: a Systematic Review and Meta-analysis

Abstract

Antimicrobial-coated sutures are significantly more efficacious for preventing SSIs during digestive and colorectal surgery, even when restricted to clean-contaminated wounds. However, the hospital stay length was not affected.

Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines

“…The superior effect of antimicrobial-coated sutures was also found in OBSs (OR 0.4, 95% CI 0.3 to 0.54, P < 0.001). The mean hospital stay length was similar to coated or uncoated sutures in 5 RCTs involving colorectal surgery (mean difference (MD) − 5.00, 95% CI 16.68-6.69, P = 0.4) [32].…”

“…Uchino et al [32] have recently analyzed the efficacy of antimicrobial-coated sutures in preventing SSIs in digestive surgery. A total of 5188 patients in 15 studies were included, with 10 randomized controlled trials (RCT) and 5 observational studies (OBS).…”

The Clinical and Economic Value of Triclosan-Coated Surgical Sutures in Abdominal Surgery

“…Nine meta-analyses were identified from database searching [28,29,[33][34][35][36][37][38][39] (Table 2). After the critical appraisal of all publications, Henriksen et al was selected as the latest meta-analysis that best matched the inclusion and exclusion criteria [28].…”

“…In both in vitro and in vivo studies, microorganisms that are responsible for SSIs were prevented from binding to and colonizing triclosan-coated sutures (TCS), with the action lasting roughly 30 days from the implantation of these sutures [15,16].Guidelines, including those issued by the US Center for Disease Control (CDC), WHO, the American College of Surgeons (ACS), and National Institute for Health and clinical Excellence (NICE), recommend the use of TCS for the prevention of SSIs [16][17][18][19].Several randomized clinical trials have investigated the efficacy of TCS in reducing SSI following abdominal surgery; some have established a positive effect of TCS, whereas others have failed to demonstrate statistically significant differences versus conventional absorbable sutures (CS) [20][21][22][23][24][25][26][27]. Recent meta-analyses reported a significant effect, or at least a positive trend, in favor of TCS over CS in reducing SSI rates following abdominal surgery [28,29]. The partial disagreement between the meta-analyses results is likely attributable to differences in the number of studies included, the degree of field contamination (CDC classification of the wounds), the heterogeneity of surgical procedures considered, and the inclusion of trials with low-level evidence, all of which introduced uncertainty in the overall interpretation of results.The purpose of this study was to critically analyze and appraise the latest available evidence on the role of TCS on SSI prevention in a more homogeneous population represented by patients undergoing abdominal surgery.…”

“…Several randomized clinical trials have investigated the efficacy of TCS in reducing SSI following abdominal surgery; some have established a positive effect of TCS, whereas others have failed to demonstrate statistically significant differences versus conventional absorbable sutures (CS) [20][21][22][23][24][25][26][27]. Recent meta-analyses reported a significant effect, or at least a positive trend, in favor of TCS over CS in reducing SSI rates following abdominal surgery [28,29]. The partial disagreement between the meta-analyses results is likely attributable to differences in the number of studies included, the degree of field contamination (CDC classification of the wounds), the heterogeneity of surgical procedures considered, and the inclusion of trials with low-level evidence, all of which introduced uncertainty in the overall interpretation of results.…”