Surgical Site Infections after Abdominal Closure in Colorectal Surgery Using Triclosan-Coated Absorbable Suture (PDS Plus) vs. Uncoated Sutures (PDS II): A Randomized Multicenter Study

Abstract

Compared with the previous retrospective studies of this department, the implementation of looped PDS decreased the incidence of SSI by one-half, whether the suture was triclosan-coated or not. It seems that patient factors are less important than operative factors in the occurrence of SSI, and there were no differences between elective colon and rectal operations in the development of incisional infections. No beneficial effect of triclosan against gram-positive bacteria, which has been reported in the literature, could be confirmed in our study. We could not show an effect against gram-negative enteric microorganisms. Higher additional costs and longer hospital stay with SSI were confirmed.

Multi-Center Randomized Controlled Trial on the Effect of Triclosan-Coated Sutures on Surgical Site Infection after Colorectal Surgery

“…Our findings are consistent with the results of Baracs et al [17], who showed in a similar population of 385 patients undergoing comparable surgical procedures an overall rate of incision infection of 12.5% with no significant difference between the group treated with triclosancoated sutures (12.2%) and uncoated sutures (12.2%). As in our study, they used a running triclosan-coated polydioxanone to close the abdominal fascia; peritoneum and subcutaneous layer closure was optional and the rate of implementation was not reported.…”

“…Until now, only three randomized controlled trials (RCTs) addressing the effect of triclosan-coated sutures in colorectal operations have been published, with inconsistent outcome. A Hungarian multicenter trial [17] failed to demonstrate any advantage of impregnated sutures on the overall rate of SSIs. Two recent single-center studies [18,19] showed a significant reduction of incision infection in patients undergoing open colorectal resection treated with triclosan-coated sutures.…”

Association between Triclosan-Coated Sutures for Abdominal Wall Closure and Incisional Surgical Site Infection after Open Surgery in Patients Presenting with Fecal Peritonitis: A Randomized Clinical Trial

“…Galal et al [12] described a reduced infection rate in a randomized study of mixed surgical patients. On the other hand, Baracs et al [13] found no difference in infection incidence in a randomized controlled trial in colorectal surgery. In a recent systematic review and metaanalysis of randomized trials with triclosan-coated sutures, Chang et al [14] concluded that triclosan-impregnated sutures do not decrease the rate of SSIs, but also indicated that the quality of the studies was moderate and further highquality independent studies are required.…”

European Hernia Society guidelines on the closure of abdominal wall incisions

“…No reduction in the incidence of surgical site infection was reported (OR 0.91: CI 0.66-1.25; p = 0.39). Four other RCT's have compared sutures with or without triclosan in laparotomy closure, either with polyglactin sutures (Vicryl) [73,74] or with polydioxanone (PDS) [75,76]. A meta-analysis on all five studies performed by Diener et al showed a significant decrease in surgical site infection (OR 0.67: CI 0.47-0.98).…”