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Effect of Fascia Closure with Triclosan-Coated Polydioxanone Suture on Surgical Site Infection in Open Appendectomy
Adewale A Aderounmu1,2, Olalekan Olasehinde1,2, Funmilola O Wuraola1,2
1Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.
Background:
Interest in surgical site infections (SSI) has been sustained over the years because its occurrence may be ruinous to the overall success of surgical operations. The use of antimicrobial suture has been associated with a reduction in SSI, but its role in open appendectomy has not been evaluated.
Objective:
This study compared the effect of fascia closure with triclosan-coated polydioxanone (PDS) with plain PDS on SSI in appendectomy wounds.
Materials And Methods:
Ninety-three consecutive patients who had open appendectomy for uncomplicated acute appendicitis were randomised to either have fascia closure with triclosan-coated PDS (TCS) or plain PDS. Post-operative wound infection rates were compared.
Results:
SSI occurred in three of the 93 patients (3.2%), two of these occurred in the plain suture group, while one occurred in the TCS group (4.2% vs. 2.2%, P = 0.6). All three SSIs were superficial. Staphylococcus aureus was the predominant organism isolated in the infected wounds.
Conclusion:
The use of triclosan-coated polydioxanone for fascia closure in open appendectomy did not significantly affect the rate or severity of SSI. Further studies, perhaps evaluating the use of TCS in a different anatomical plane or complicated appendicitis are recommended.
Insights
Antimicrobial sutures did not significantly reduce surgical site infections (SSI) in open appendectomy patients. Triclosan-coated polydioxanone sutures showed no significant benefit over plain sutures for preventing SSI in this study.
Area of Science:
- Surgical infection control
- Wound healing
- Antimicrobial materials
Background:
- Surgical site infections (SSI) are a significant complication impacting surgical outcomes.
- Antimicrobial sutures have shown promise in reducing SSI, but their efficacy in open appendectomy remains unevaluated.
Purpose of the Study:
- To compare the efficacy of triclosan-coated polydioxanone (TCS PDS) versus plain PDS for fascia closure in preventing SSI after open appendectomy.
Main Methods:
- A randomized controlled trial involving 93 patients undergoing open appendectomy for uncomplicated acute appendicitis.
- Patients were randomized to receive fascia closure with either TCS PDS or plain PDS.
- Post-operative wound infection rates were monitored and compared between the two groups.
Main Results:
- Overall SSI rate was 3.2% (3 out of 93 patients).
- The SSI rate in the triclosan-coated PDS group was 2.2% (1/46), compared to 4.2% (2/47) in the plain PDS group (P=0.6).
- All identified SSIs were superficial, with Staphylococcus aureus being the predominant pathogen.
Conclusions:
- Fascia closure with triclosan-coated polydioxanone did not significantly reduce the incidence or severity of SSI in open appendectomy.
- Further research is warranted to explore TCS efficacy in different surgical planes or for complicated appendicitis cases.
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