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Antimicrobial-impregnated Sutures Reduce Surgical Site Infections in Plastic Surgery: A Systematic Review and
Sarah Petrecca1, Simran K Chandawarkar2, Hassan ElHawary3
1From the Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Background:
Surgical site infections (SSIs) are a common complication in plastic surgery, contributing to increased morbidity, prolonged recovery, and increased healthcare costs. Antimicrobial-impregnated sutures (AISs) have shown promise in reducing SSI rates across surgical disciplines. However, their efficacy in plastic surgery remains unclear.
Methods:
This review followed PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-Analysis) 2020 guidelines. PubMed and Web of Science were searched for comparative studies assessing AIS use. Seven studies were identified. Data extracted included patient demographics, study variables, and postoperative outcomes. SSI rates were pooled using a random-effects model and reported as a risk ratio (RR) with 95% confidence intervals (CIs). Analyses of wound healing/outcomes were performed using Fisher exact tests.
Results:
In a pool of 1553 patients (807 intervention, 746 control), AIS use was associated with a significant reduction in SSIs (RR 0.68, 95% CI [0.51-0.90], P = 0.0066). This effect was pronounced in abdominal surgery (RR 0.51, 95% CI [0.35-0.74], P = 0.0004) but not significant in breast surgery (RR 0.71, 95% CI [0.44-1.15], P = 0.1657). AISs significantly improved cosmetic outcomes (RR 0, 95% CI [0-0.2058], P < 0.0001).
Conclusions:
AISs are associated with improved postoperative outcomes, particularly in reducing incidence of SSIs and improving cosmetic outcomes. Although these findings support the use of AISs in plastic surgery procedures, randomized controlled trials comparing antimicrobial agents and their use in different anatomical areas are warranted to establish definitive clinical guidelines.
Insights
Antimicrobial-impregnated sutures (AISs) significantly reduce surgical site infections (SSIs) in plastic surgery, especially in abdominal procedures. AISs also enhance cosmetic results, supporting their use in plastic surgery.
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.