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Triclosan-Coated Sutures Reduce the Risk of Surgical Site Infections: A Systematic Review and Meta-analysis

Published online by Cambridge University Press:  09 January 2015

Anucha Apisarnthanarak ,
Nalini Singh ,
Aila Nica Bandong  and
Gilbert Madriaga
Anucha Apisarnthanarak*
Affiliation:
Division of Infectious Diseases, Thammasat University Hospital, Pratumthani, Thailand 12120
Nalini Singh
Affiliation:
Division of Infectious Diseases, Children’s National Medical Center, Department of Pediatrics, Epidemiology and Global Health, George Washington University, School of Medicine and Health Sciences, School of Public Health, Washington DC 20010
Aila Nica Bandong
Affiliation:
College of Allied Medical Professions, University of the Philippines–Manila, Pedro Gil St, Ermita, Manila, Philippines 1000
Gilbert Madriaga
Affiliation:
College of Public Health, University of the Philippines–Manila, Pedro Gil St, Ermita, Manila, Philippines 1000
*
Address correspondence to Anucha Apisarnthanarak, MD, Division of Infectious Diseases, Thammasat University Hospital, Pratumthani, Thailand 12120 (anapisarn@yahoo.com).
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Abstract

OBJECTIVE

To analyze available evidence on the effectiveness of triclosan-coated sutures (TCSs) in reducing the risk of surgical site infection (SSI).

DESIGN

Systematic review and meta-analysis.

METHODS

A systematic search of both randomized (RCTs) and nonrandomized (non-RCT) studies was performed on PubMed Medline, OVID, EMBASE, and SCOPUS, without restrictions in language and publication type. Random-effects models were utilized and pooled estimates were reported as the relative risk (RR) ratio with 95% confidence interval (CI). Tests for heterogeneity as well as meta-regression, subgroup, and sensitivity analyses were performed.

RESULTS

A total of 29 studies (22 RCTs, 7 non-RCTs) were included in the meta-analysis. The overall RR of acquiring an SSI was 0.65 (95% CI: 0.55–0.77; I2=42.4%, P=.01) in favor of TCS use. The pooled RR was particularly lower for the abdominal surgery group (RR: 0.56; 95% CI: 0.41–0.77) and was robust to sensitivity analysis. Meta-regression analysis revealed that study design, in part, may explain heterogeneity (P=.03). The pooled RR subgroup meta-analyses for randomized controlled trials (RCTs) and non-RCTs were 0.74 (95% CI: 0.61–0.89) and 0.53 (95% CI: 0.42–0.66), respectively, both of which favored the use of TCSs.

CONCLUSION

The random-effects meta-analysis based on RCTs suggests that TCSs reduced the risk of SSI by 26% among patients undergoing surgery. This effect was particularly evident among those who underwent abdominal surgery.

Infect Control Hosp Epidemiol 2015;36(2): 1–11

Information

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 2 , February 2015 , pp. 169 - 179
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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