Triclosan-impregnated sutures to decrease surgical site infections: systematic review and meta-analysis of randomized...

Area of Science:

• Infectious Disease
• Surgical Innovation
• Evidence-Based Medicine

Background:

• Surgical-site infections (SSIs) are a significant cause of patient morbidity and increased healthcare costs.
• Triclosan-impregnated sutures are proposed as a strategy to reduce SSIs.
• Previous reviews suggest potential benefits, but a comprehensive assessment of clinical efficacy and safety is lacking.

Purpose of the Study:

• To systematically review and meta-analyze randomized controlled trials (RCTs) on the efficacy and safety of triclosan-impregnated sutures.
• To determine the impact of triclosan-impregnated sutures on the incidence of SSIs.
• To assess the effect on wound breakdown rates.

Main Methods:

• A systematic search of multiple databases (Cochrane, MEDLINE, EMBASE, Pubmed) and trial registries was performed for RCTs.
• Data from seven RCTs involving 836 patients were analyzed.
• A random effects model was used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs) for SSIs and wound breakdown.

Main Results:

• Triclosan-impregnated sutures did not show a statistically significant reduction in the rates of SSIs (OR = 0.77; 95% CI: 0.40-1.51).
• No significant difference was observed in wound breakdown rates between triclosan-impregnated sutures and control groups (OR = 1.07; 95% CI: 0.21-5.43).
• The included studies were of moderate quality.

Conclusions:

• Current evidence indicates that triclosan-impregnated sutures do not decrease the incidence of SSIs or wound breakdown.
• High-quality, independent studies are necessary to evaluate the clinical utility of these sutures.
• Routine clinical adoption of triclosan-impregnated sutures is not supported by this meta-analysis.