Triclosan-coated sutures reduce wound infections after hepatobiliary surgery--a prospective non-randomized clinical pathway driven study.

摘要

OBJECTIVES: Wound infections after abdominal surgery are still frequent types of nosocomial infections. Suture materials might serve as a vehicle for mechanical transport of bacteria into the surgical wound. To reduce bacterial adherence to surgical sutures, triclosan-coated polyglactin 910 suture materials with antiseptic activity (Vicryl plus(R)) were developed. The aim of this prospective non-randomized clinical pathway driven study was to ascertain if the use of Vicryl plus(R) reduced the number of wound infections after transverse laparotomy. PATIENTS AND METHODS: Between October 2003 and October 2007, 839 operations were performed using a transverse abdominal incision. In the first time period, a PDSII(R) loop suture was used for abdominal wall closure. In the second time period, we used Vicryl plus(R). Risk factors were collected prospectively to compare the two groups. RESULTS: Using a PDSII(R) loop suture for abdominal wall closure in the first time period, 9.2% of the patients developed wound infections. In the second time period, using Vicryl plus(R), the number of wound infections decreased to 4.3% (p < 0,005). Both groups were comparable regarding risk factors despite no other changes in protocols of patient care. CONCLUSION: Antiseptic-coated loop Vicryl suture for abdominal wall closure can be superior to PDSII sutures in respect to the development of wound infections after a two-layered closure of transverse laparotomy.