Triclosan coated vicryl versus uncoated vicryl in preventing surgical site infection: a randomized controlled trial
DOI:
https://doi.org/10.18203/2349-2902.isj20205820Keywords:
Surgical site infection, Triclosan coated vicryl, Uncoated vicryl, Vicryl plusAbstract
Background: Surgical site infection (SSI) are one of the most frequently reported health care associated infections. They are commonly associated with greater morbidity, readmissions, ICU admissions, long-term surgical site complications and mortality. Multiple global studies have shown level 1A clinical evidence that the use of triclosan coated suture reduces the incidence of SSI by 30%.
Methods: In the proposed prospective study, 100 cases undergoing elective surgery were randomly allocated into Group A and B. Group A were the patients in which wound closure was done using triclosan coated vicryl (vicryl plus) and group B were the patients in which wound closure was done using uncoated vicryl. Then, the patients were followed up for 30 days to observe any signs and symptoms of surgical site infection.
Results: Duration as well as severity of pain was decreased in vicryl plus group as compared to uncoated vicryl. Other signs of inflammation such as erythema, swelling, induration and fever were also less in patients who had wound closure using vicryl plus. Wound dehiscence was not observed in either of the groups. Discharge was seen in 1 patient in vicryl plus group but it was seen in 5 patients in uncoated vicryl group. Surgical site infection was seen only in 1 patient in the vicryl plus group, but it was seen in 10 patients uncoated vicryl group.
Conclusions: It can be concluded that triclosan coated vicryl (vicryl plus) is better than uncoated vicryl for the prevention of surgical site infection.
References
Chu K, Maine R, Trelles M. Cesarean section surgical site infections in sub-Saharan Africa: a multi-country study from Medecins Sans Frontieres. World J Surg. 2015;39(2):350-5.
Anderson DJ, Podgorny K, Berrios-Torres SI, Bratzler DW, Dellinger EP, Greene L, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35(S2):S66-88.
Mukagendaneza MJ, Munyaneza E, Muhawenayo E, Nyirasebura D, Abahuje E, Nyirigira J, et al. Incidence, root causes, and outcomes of surgical site infections in a tertiary care hospital in Rwanda: a prospective observational cohort study. Patient Safety Surg. 2019;13(1):10.
Akhter MS, Verma R, Madhukar KP, Vaishampayan AR, Unadkat PC. Incidence of surgical site infection in postoperative patients at a tertiary care centre in India. J Wound Care. 2016;25(4):210-7.
Pathak A, Mahadik K, Swami MB, Roy PK, Sharma M, Mahadik VK, et al. Incidence and risk factors for surgical site infections in obstetric and gynecological surgeries from a teaching hospital in rural India. Antimicrob Resist Infect Control. 2017;6(1):66.
Surgical Site Infection (SSI) Event. Available at: https://www.cdc.gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf. Accessed on 22 January 2019.
Diener MK, Knebel P, Kieser M, Schüler P, Schiergens TS, Atanassov V, et al. Effectiveness of triclosan-coated PDS Plus versus uncoated PDS II sutures for prevention of surgical site infection after abdominal wall closure: the randomised controlled PROUD trial. Lancet. 2014;384(9938):142-52.
Ahmed I, Boulton AJ, Rizvi S, Carlos W, Dickenson E, Smith NA, et al. The use of triclosan-coated sutures to prevent surgical site infections: a systematic review and meta-analysis of the literature. BMJ Open. 2019;9(9):e029727.
De Simone S, Gallo AL, Paladini F, Sannino A, Pollini M. Development of silver nano-coatings on silk sutures as a novel approach against surgical infections. J Materials Sci Materials Med. 2014;25(9): 2205-14.
Gallo AL, Paladini F, Romano A, Verri T, Quattrini A, Sannino A, et al. Efficacy of silver coated surgical sutures on bacterial contamination, cellular response and wound healing. Materials Sci Engin. 2016;69:884-93.
Gristina AG, Costerton JW. Bacterial adherence to biomaterials and tissue. The significance of its role in clinical sepsis. JBJS. 1985;67(2):264-73.
Leaper D, Wilson P, Assadian O, Edmiston C, Kiernan M, Miller A, et al. The role of antimicrobial sutures in preventing surgical site infection. Ann Royal Coll Surg Engl. 2017;99(6):439-43.
Velvart P, Peters CI, Peters OA. Soft tissue management: suturing and wound closure. Endodont Topics. 2005;11(1):179-95.
Merritt K, Hitchins VM, Neale AR. Tissue colonization from implantable biomaterials with low numbers of bacteria. J Biomed Materials Res. 1999;44(3):261-5.
Shunmugaperumal T. Microbial colonization of medical devices and novel preventive strategies. Rec Patents Drug Deliv Formul. 2010;4(2):153-73.
Reinbold J, Uhde AK, Müller I, Weindl T, Geis-Gerstorfer J, Schlensak C, et al. Preventing surgical site infections using a natural, biodegradable, antibacterial coating on surgical sutures. Molecules. 2017;22(9):1570.
Dennis C, Sethu S, Nayak S, Mohan L, Morsi Y, Manivasagam G. Suture materials- current and emerging trends. J Biomed Materials Res Part A. 2016;104(6):1544-59.
Mingmalairak C. Antimicrobial sutures: new strategy in surgical site infections. Science against Microbial Pathogens: Communicating Current Research and Technological Advances: Formatex Research Center. 2011;313:23.
Rothenburger S, Spangler D, Bhende S, Burkley D. In vitro antimicrobial evaluation of coated VICRYL* plus antibacterial suture (coated polyglactin 910 with triclosan) using zone of inhibition assays. Surg Infect. 2002;3(S1):s79-87.
Fleck T, Moidl R, Blacky A, Fleck M, Wolner E, Grabenwoger M, et al. Triclosan-coated sutures for the reduction of sternal wound infections: economic considerations. Ann Thorac Surg. 2007;84(1):232-6.
Storch M, Scalzo H, Van Lue S, Jacinto G. Physical and functional comparison of coated VICRYL* plus antibacterial suture (coated polyglactin 910 suture with triclosan) with Coated VICRYL* suture (coated polyglactin 910 suture). Surg Infect. 2002;3(S1):s65-77.
Agrawal A, Madeshiya S, Khan R, Tripathi SS, Bharadwaj G. Evaluation of patient related modifiable and non-modifiable risk factors in causation of surgical site infection in various abdominal surgeries. Int Surg J. 2018;6(1):265-70.
Kathju S, Nistico L, Tower I, Lasko LA, Stoodley P. Bacterial biofilms on implanted suture material are a cause of surgical site infection. Surg Infect. 2014;15(5):592-600.
Dhom J, Bloes DA, Peschel A, Hofmann UK. Bacterial adhesion to suture material in a contaminated wound model: Comparison of monofilament, braided, and barbed sutures. J Orthopaed Res. 2017;35(4):925-33.
Mulay MV, Pohekar JA. In vitro comparison of efficacy of triclosan coated and uncoated sutures against the bacteria isolated from SSI at tertiary care hospital, Aurangabad. Indian J Microbiol Res. 2020;7(1):91-4.
Ford HR, Jones P, Gaines B, Reblock K, Simpkins DL. Intraoperative handling and wound healing: controlled clinical trial comparing coated VICRYL® Plus antibacterial suture (coated polyglactin 910 suture with triclosan) with Coated VICRYL® suture (coated polyglactin 910 suture). Surg Infect. 2005; 6(3):313-21.
Jung KH, Oh SJ, Choi KK, Kim SM, Choi MG, Lee JH, et al. Effect of triclosan-coated sutures on surgical site infection after gastric cancer surgery via midline laparotomy. Annals of Surgical Treatment and Research. 2014;87(6):311-8.
Laas E, Poilroux C, Bézu C, Coutant C, Uzan S, Rouzier R, et al. Antibacterial-coated suture in reducing surgical site infection in breast surgery: a prospective study. Int J Breast Cancer. 2012;2012.
Arslan NC, Atasoy G, Altintas T, Terzi C. Effect of triclosan-coated sutures on surgical site infections in pilonidal disease: prospective randomized study. Int J Colorect Dis. 2018;33(10):1445-52.
Rašić Ž, Schwarz D, Nesek Adam V, Sever M, Lojo N, Rašić D, et al. Efficacy of antimicrobial triclosan-coated polyglactin 910 (Vicryl* Plus) suture for closure of the abdominal wall after colorectal surgery. Colleg Antropologic. 2011;35(2):439-43.