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Antibacterial Sutures for Wound Closure After Surgery: A Review of Clinical and Cost-Effectiveness and Guidelines for Use [Internet].


Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2014 Nov.
CADTH Rapid Response Reports.


Surgical site infections (SSIs) account for approximately 20% of all compromised wounds in the Canadian healthcare setting. It is estimated that 6.3% of surgical wounds in Canada result in infection. An overall SSI rate of 2.5% was reported in a sample of hospitalized adults across Canada. In addition to increasing the risk of morbidity, delayed recovery, and prolonged hospital stay, SSIs may increase Canadian healthcare costs associated with surgical procedures. It is estimated that the incidence of SSIs could be reduced by over 50% with the implementation of various evidence-based prevention strategies. Risk factors for SSIs include patient related factors (e.g., diabetes, obesity), category of wound (e.g., clean, clean-contaminated), bacterial species, and hospital-related infection prevention measures. Sutures may act as a medium for bacterial growth and it has been demonstrated by in-vitro and in-vivo animal studies that antimicrobial coating may reduce the risk of SSIs. Antimicrobial sutures, which are currently commercially limited to triclosan coated sutures (TCS) (e.g., Vicryl [polyglactin 910] Plus, Monocryl [poliglecaprone 25] Plus, PDS [polydioxanone] Plus), are targeted for the prevention of SSIs. Although antimicrobial sutures are more costly than conventional sutures, if effective for SSI prevention they may reduce surgery related costs. The reported clinical efficacy of antimicrobial sutures is inconsistent, with some systematic reviews reporting an overall benefit, while others do not. A previous CADTH report summarized evidence suggesting that TCS reduced SSIs compared to non-coated sutures. This report will provide an update and augment a recent CADTH Rapid Response reference list.

Copyright © 2014 Canadian Agency for Drugs and Technologies in Health.

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