Effect of Triclosan-Coated Suture on Surgical Site Infection of Abdominal Fascial Closures

Ölmez, Tolga; Berkeşoğlu, Mustafa; Türkmenoğlu, Özgür; Çolak, Tahsin

doi:10.1089/sur.2019.052

Cited by 19 publications

(30 citation statements)

References 16 publications

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“…Following publication of the above mentioned meta-analysis, two additional RCTs that investigated the role of TCS in abdominal surgery were identified [40,41]. Ichida et al [41] evaluated 1013 adult patients undergoing both laparoscopic and open gastrointestinal operations; the authors declared full adherence to the WHO recommendations for SSI prevention.…”

Section: Clinical Resultsmentioning

confidence: 99%

“…Olmez et al [40] reported a RCT that investigated the effect of triclosan-coated monofilament polydioxanone (PDS) compared to standard PDS on SSI incidence after laparotomy for any type of gastrointestinal disease in 890 patients. The Consolidated Standards of Reporting Trials diagram of the randomization process and the concealment assignment were not available.…”

Section: Clinical Resultsmentioning

confidence: 99%

“…However, it should be noted that intervention type (elective versus emergency), target organs, and the lack of implementation of recognized peri-operative strategies to reduce SSI likely limit the ability to define the true effect of TCS, adding high heterogeneity and possible confounders. Two additional RCTs [40,41] that were published afterwards did not contribute to solving these uncertainties.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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Surgical site infection (SSI) is a frequent complication of surgical procedures. The aim of this study was to analyze the clinical evidence for SSI prevention with triclosan-coated sutures (TCS) in abdominal surgery and to investigate the economic impact of TCS in this type of procedure compared with conventional absorbable sutures (CS). A literature review was carried out to identify meta-analyses that were published between 1990 and 2019 that assessed the use of TCS in abdominal surgery. A budget impact analysis was performed from an Italian hospital perspective based on the most recently published evidence to simulate the financial impact of TCS in a general surgery unit. Uncertainty was explored through scenario analysis, as well as deterministic and probabilistic sensitivity analyses. Nine meta-analyses and two additional randomized clinical trials were retrieved. All meta-analyses described a reduction (range 19%–44%) in the risk of SSI when TCS were used. The use of TCS was associated with an overall annual net saving for the general surgery unit of €14,785 and a reduction of 3.2 SSIs compared with CS. Sensitivity analyses resulted in a positive annual saving associated with TCS in 98% of scenarios. TCS are a valuable, cost-saving SSI prevention strategy. TCS additional costs would be offset by the reduction in SSIs.

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Section: Clinical Resultsmentioning

confidence: 99%

Section: Clinical Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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“…). After final review, data from 34 distinct studies were included in the final assessment, yielding a total of 38 data points (2 studies had multiple SSIs per surgical wound type). Surgical wound types in the included study list are shown in Table S2 (supporting information).…”

Section: Resultsmentioning

confidence: 99%

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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“…The SSIs continue to be a significant cause of morbidity after colorectal cancer surgical procedures. Although various methods to reduce the incidence of infections have been reported in recent years, the rate of infection has not dropped below negligible levels, and the length of hospital stay continues to be long [15]. A large number of risk factors have been identified after colorectal operations in which diabetes mellitus, obesity, prolonged operative time, and a non-laparoscopic approach have been commonly implicated [16,17].…”

Section: Discussionmentioning

confidence: 99%

Relationship between Sarcopenia and Surgical Site Infection in Patients Undergoing Colorectal Cancer Surgical Procedures

Ölmez

Karakose

Keklikkıran

et al. 2020

Surgical Infections

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Background: Sarcopenia is a syndrome that can be associated with unfavorable outcomes after colorectal cancer surgical procedures. The present study evaluates the relationship between sarcopenia and surgical site infections (SSIs) that can occur after colorectal cancer operations and that are a significant cause of morbidity. Methods: The research was designed as a retrospective study in which data were collected on patients who underwent colorectal cancer surgical procedures between January 2013 and July 2019. A diagnosis of sarcopenia was established based on the skeletal muscle index (SMI), calculated from pre-operative computed tomography scans. The SSI scores of patients with sarcopenia (sarcopenic group, SG) and those without sarcopenia (non-sarcopenic group, NSG) were compared, and a logistic regression analysis was performed to determine the risk factors for SSI. Results: A total of 209 patients with a mean age of 61.2 years were included in the study. Post-operative complications (Clavien-Dindo ‡1) developed in 97 (46.4%) patients, SSIs developed in 46 (22%) patients, and sarcopenia developed in 97 (46.4%) patients. The mean age was 64.8 years in the SG group and 58.1 years in the NSG group (p = 0.016). No significant relationship was found between the development of SSI and sarcopenia (20 (20.6%) patients in the SG vs. 26 (23.2%) patients in the NSG, p = 0.65). Those in whom superficial SSIs developed in the early period formed the largest group (20 patients). The most commonly detected microorganism was Escherichia coli with a rate of 55%. In a multi-variable logistic regression analysis, only the nonlaparoscopic approach was identified as a risk factor (odds ratio 3.83; 95% confidence interval 1.26-11.58; p = 0.017). Conclusions: The present study reports no relationship between sarcopenia and SSI after colorectal cancer operations. The authors consider that studies that endeavor to reduce the incidence of SSI, as a significant cause of morbidity after colorectal surgical procedures, should be supported.

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Effect of Triclosan-Coated Suture on Surgical Site Infection of Abdominal Fascial Closures

Cited by 19 publications

References 16 publications

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

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

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

Relationship between Sarcopenia and Surgical Site Infection in Patients Undergoing Colorectal Cancer Surgical Procedures

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