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Surgery. 2013 Sep;154(3):589-95. doi: 10.1016/j.surg.2013.04.011. Epub 2013 Jul 13.

Surgical-site infection after abdominal wall closure with triclosan-impregnated polydioxanone sutures: results of a randomized clinical pathway facilitated trial (NCT00998907).

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1
Department of General and Visceral Surgery, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany.

Abstract

BACKGROUND:

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 prevent the contamination of suture material in surgical wounds, triclosan-coated suture materials with antibacterial activity was developed. We here report a prospective randomized pathway controlled trial investigating the effect of triclosan impregnation of polydioxanone sutures used for abdominal wall closure on the rate of surgical-site infections.

PATIENTS AND METHODS:

A total of 856 patients included in this trial underwent a standardized clinical pathway documented abdominal wall closure after abdominal surgery. Patients were randomized to have the fascia closed with either a 2-0 polydioxanone loop or a triclosan impregnated 2-0 polydioxanone loop. The primary outcome was the number of wound infections. Risk factors for poor wound healing were collected prospectively to compare the two groups.

RESULTS:

When a PDS loop suture for abdominal wall closure was used, 42 (11.3%) patients with wound infections were detected. The number of patients with wound infections decreased significantly to 31 when the PDS plus for abdominal wall closure was used (6.4%, P < .05). Other risk factors for the development of side infections were comparably in the two groups.

CONCLUSION:

This clinical pathway facilitated trial shows that triclosan impregnation of a 2-0 polydioxanone closing suture can decrease wound infections in patients having a laparotomy for general and abdominal vascular procedures.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00998907.

PMID:
23859304
DOI:
10.1016/j.surg.2013.04.011
[Indexed for MEDLINE]
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