Antimicrobial-impregnated Sutures Reduce Surgical Site Infections in Plastic Surgery: A Systematic Review and...

Area of Science:

• Plastic Surgery
• Infectious Disease Control
• Surgical Innovation

Background:

• Surgical site infections (SSIs) are a significant concern in plastic surgery, leading to increased patient morbidity and healthcare costs.
• Antimicrobial-impregnated sutures (AISs) show potential for SSI reduction in various surgical fields, but their specific efficacy in plastic surgery requires clarification.

Purpose of the Study:

• To systematically review and meta-analyze the efficacy of antimicrobial-impregnated sutures (AISs) in reducing surgical site infections (SSIs) within plastic surgery.
• To evaluate the impact of AISs on postoperative outcomes, including wound healing and cosmetic results, in plastic surgery patients.

Main Methods:

• A systematic review and meta-analysis adhering to PRISMA 2020 guidelines was conducted.
• Comparative studies on AIS use in plastic surgery were identified via PubMed and Web of Science searches.
• Pooled analysis of SSI rates using a random-effects model and Fisher exact tests for wound healing outcomes were performed.

Main Results:

• A meta-analysis of 1553 patients revealed that AIS use significantly reduced SSIs (RR 0.68, P=0.0066).
• The reduction in SSIs was particularly pronounced in abdominal surgery (RR 0.51, P=0.0004) but not statistically significant in breast surgery (RR 0.71, P=0.1657).
• AISs demonstrated a significant improvement in cosmetic outcomes (RR 0, P<0.0001).

Conclusions:

• Antimicrobial-impregnated sutures (AISs) are associated with reduced SSIs and improved cosmetic outcomes in plastic surgery.
• Findings support the use of AISs in plastic surgery, particularly for abdominal procedures.
• Further randomized controlled trials are needed to establish definitive guidelines for AIS use across different anatomical regions and antimicrobial agents.