Can triclosan-coated sutures reduce the postoperative rate of wound infection? Data from a systematic review and meta-analysis

Wound infections are typical postoperative complications with considerable therapeutic consequences and high personnel and financial costs. Previous meta-analyses have shown that triclosan-coated sutures can reduce the risk of postoperative wound infection. This work aimed to update previous meta-analyses with a special focus on different subgroups.

A systematic review with meta-analysis was performed (registration: PROSPERO 2022 CRD42022344194). The search was independently performed in the Web of Science, PubMed, and Cochrane databases by 2 reviewers. A critical methods review of all included full texts took place. The trustworthiness of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation method. An analysis of the cost-effectiveness of the suture material was carried out.

In this meta-analysis of 29 randomized controlled trials, the use of triclosan-coated suture material resulted in a significant reduction of postoperative wound infection rate (24%) (random-effects model; risk ratio: 0.76; 95% confidence interval: [0.67-0.87]). The effect was evident in the subgroups according to wound contamination class, underlying oncologic disease, and pure preoperative antibiotic prophylaxis. In the subgroup analysis by the operating department, the significant effect was visible only in the abdominal surgery group.

Based on the randomized controlled clinical trials reviewed, triclosan-coated sutures reduced postoperative wound infection rates in the main study and most subgroups. Additional costs of up to 12 euros for the coated suture material appear to be justified to generate an economic benefit for the hospital by reducing postoperative wound infections. The additional socioeconomic benefit of reducing wound infection rates was not investigated here.