Effect of triclosan-coated sutures on surgical site infections in pilonidal disease: prospective randomized study

The aim of this study is to investigate the effect of triclosan-coated sutures on surgical site infections after wide excision and primary closure for pilonidal disease.

One hundred seventy-seven patients were randomized into two groups: 91 in control and 86 in triclosan groups. In the control group, 1/0 monofilament polypropylene retention sutures, 3/0 polyglactin subcutaneous sutures, and 3/0 polypropylene skin sutures were used. In the triclosan group, 1/0 triclosan-coated monofilament polydioxanone, 3/0 triclosan-coated polyglactin, and 3/0 triclosan-coated monofilament polydioxanone were used. Postoperative care and follow-up was made by a surgeon according to Centers for Disease Control guideline. Surgical site infection rates between groups were compared. Secondary outcomes were seroma and wound dehiscence.

Seroma was seen in 30 (16.9%) patients: 20 (23.3%) in the triclosan group and 10 (10.9%) in the control group (p = 0.030). Thirteen (7.3%) patients had superficial wound dehiscence: 5 (5.5%) patients in the control group and 10 (11.6%) patients in the triclosan group (p = 0.116). Overall surgical site infection (SSI) rate was 15.8% (n = 28): 19 (20.8%) patients in the control group and 9 (10.5%) patients in the triclosan group (p = 0.044). Healing was observed on mean 17.8 ± 6.7 days. Primary and secondary healing rates and time to healing were similar between groups.

Triclosan-coated sutures decreased surgical site infection rate but had no effect on time to healing in pilonidal disease. Seroma and wound dehiscence were more common in triclosan groups. Randomized trials are needed to clear the effect of triclosan-coated sutures on postoperative wound complications.