• J. Am. Coll. Surg. · Jun 2022

    Multicenter Study Meta Analysis

    Effectiveness of Triclosan-Coated Sutures Compared with Uncoated Sutures in Preventing Surgical Site Infection after Abdominal Wall Closure in Open/Laparoscopic Colorectal Surgery.

    • Norikatsu Miyoshi, Shiki Fujino, Junichi Nishimura, Yozo Suzuki, Masami Ueda, Mamoru Uemura, Matkoto Fujii, Kohei Murata, Yuichiro Doki, Hidekazu Eguchi, Clinical Study Group of Osaka University, Colorectal Cancer Treatment Group (CSGOCG), and and.
    • From the Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan (Miyoshi, Fujino, Uemura, Doki, Eguchi).
    • J. Am. Coll. Surg. 2022 Jun 1; 234 (6): 114711591147-1159.

    BackgroundPrevious randomized trials have assessed the effectiveness of triclosan-coated sutures in fascia closure after midline laparotomy in preventing surgical site infections (SSIs); however, available evidence remain inconclusive. We aimed to evaluate the effectiveness of triclosan-coated sutures in abdominal fascia closure to prevent postoperative SSIs.Study DesignThis study was a multicenter prospective trial conducted within 24 Japanese secondary and tertiary care centers and a propensity score (PS)-matched analysis. Patients 20 years of age or older who underwent elective surgery for colorectal cancer (CRC) were included. Between July 2016 and July 2019, 2,207 patients were prospectively enrolled into the triclosan-coated sutures or uncoated sutures groups. The per-protocol population comprised 2,195 patients. The PS matching was performed for 1,579 patients: 926 patients in the coated group and 653 patients in the uncoated group. The abdominal fascia after midline laparotomy was closed with triclosan-coated or uncoated sutures depending on group. The primary endpoint was the incidence of an SSI. Secondary endpoints were length of hospital stay and surgical complication rates.ResultsThe recorded SSI rates were 4.2% in the triclosan-coated group and 6.74% in the uncoated suture group (p = 0.028). There were no serious adverse events in the groups. The final logistic regression model showed that several variables affected the occurrence of SSI. Our meta-analysis included six phase-III trials, and our study evaluated 4,797 patients. The results show a significant superiority of triclosan-coated sutures over uncoated suture material.ConclusionTriclosan-coated sutures reduce the incidence of SSI after elective CRC surgery.Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Surgeons.

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