open access publication

Article, 2024

Systematic review and meta-analysis comparing surgical site infection in abdominal surgery between triclosan-coated and uncoated sutures

Hernia, ISSN 1248-9204, 1265-4906, Pages 1-11, 10.1007/s10029-024-03045-5

Contributors

Depuydt, Martijn (Corresponding author) [1] [2] Van Egmond, Sarah 0000-0002-4709-4759 (Corresponding author) [3] [4] Petersen, Stine Mette [5] Muysoms, Filip E [2] Henriksen, Nadia Abdelaal 0000-0002-1805-9866 [5] Deerenberg, Eva Barbara 0000-0002-1421-8567 [4]

Affiliations

  1. [1] Ghent University
    2. [NORA names: Belgium; Europe, EU; OECD];
  2. [2] AZ Maria Middelares
    3. [NORA names: Belgium; Europe, EU; OECD];
  3. [3] Erasmus MC
    4. [NORA names: Netherlands; Europe, EU; OECD];
  4. [4] Sint Franciscus Gasthuis
    5. [NORA names: Netherlands; Europe, EU; OECD];
  5. [5] Herlev Hospital
    6. [NORA names: Capital Region of Denmark; Hospital; Denmark; Europe, EU; Nordic; OECD]

Abstract

PurposeSurgical site infection (SSI) is a frequent complication after abdominal surgery and impacts morbidity, mortality and medical costs. This systematic review evaluates whether the use of triclosan-coated sutures for closing the fascia during abdominal surgery reduces the rate of SSI compared to uncoated sutures.MethodsA systematic review and meta-analysis were conducted using the PRISMA guidelines. On February 17, 2024, a literature search was performed in Medline ALL, Web of Science Core Collection, Cochrane Central Register of Controlled Trials and Embase. Randomized controlled trials (RCTs) on abdominal fascial closure in human adults, comparing triclosan-coated and uncoated sutures, were included. The risk of bias was assessed using the Cochrane RoB 2 tool. Pooled meta-analysis was performed using RevMan.ResultsOut of 1523 records, eleven RCTs were included, with a total of 10,234 patients: 5159 in the triclosan-coated group and 5075 in the uncoated group. The incidence of SSI was statistically significantly lower in the triclosan-coated group (14.8% vs. 17.3%) with an odds ratio (OR) of 0.84 (95% CI [0.75, 0.93], p = 0.001). When polydioxanone was evaluated separately (coated N = 3999, uncoated N = 3900), triclosan-coating reduced SSI; 17.5% vs. 20.1%, OR 0.86 (95% CI [0.77; 0.96], p = 0.008). When polyglactin 910 was evaluated (coated N = 1160, uncoated N = 1175), triclosan-coating reduced the incidence of SSI; 5.4% vs. 7.8%, OR 0.67 (95% CI [0.48; 0.94], p = 0.02).ConclusionAccording to the results of this meta-analysis the use of triclosan-coated sutures for fascial closure statistically significantly reduces the incidence of SSI after abdominal surgery with a risk difference of about 2%.

Keywords

ALL, Central Register of Controlled Trials, Cochrane, Cochrane Central Register, Cochrane Central Register of Controlled Trials, Cochrane RoB 2 tool, Embase, MEDLINE, MEDLINE ALL, MethodsA, MethodsA systematic review, PRISMA, PRISMA guidelines, PurposeSurgical site infection, Register of Controlled Trials, ResultsOut, RevMan, RoB 2 tool, SSI, Science Core Collection, Web, Web of Science Core Collection, abdominal fascial closure, abdominal surgery, adults, bias, closure, collection, complications, controlled trials, core collection, cost, differences, fascia, fascial closure, frequent complication, group, guidelines, human adults, impact morbidity, incidence, incidence of SSI, infection, literature, literature search, medical costs, meta-analysis, morbidity, mortality, odds, odds ratio, patients, polydioxanone, polyglactin, pooled meta-analysis, randomized controlled trials, rate, rate of SSI, ratio, records, results, review, risk, risk difference, risk of bias, search, site infection, surgery, surgical site infection, suture, systematic review, trials, triclosan-coated, triclosan-coated sutures, uncoated group, uncoated sutures

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