[Prevention of surgical infection using reabsorbable antibacterial suture (Vicryl Plus) versus reabsorbable conventional suture in hernioplasty. An experimental study in animals].
BACKGROUND
Surgical site infections are frequent in daily surgical practice. One of the main challenges currently facing surgeons is the prevention and treatment of infections, especially those involving prosthetic material. A new suture (Vicryl Plus) has become available. In vitro studies and experimental models have demonstrated the ability of this suture to inhibit bacterial growth and consequently prevent postsurgical infection.


OBJECTIVE
To compare infections provoked in prosthetic implants fixed with reabsorbable conventional sutures with those in meshes fixed with reabsorbable sutures with antiseptic impregnation.


METHODS
Twenty white Wistar rats were used. In each rat, two hernioplasties were performed: one fixed with Vicryl Plus and the other with normal Vicryl. Subsequently, each polypropylene mesh was infected with S. aureus, and the rats remained in individual cages for a week. After 1 week, the rats were sacrificed and the meshes were extracted for macroscopic, microscopic and microbiologic study.


RESULTS
Most of the meshes fixed with the new suture (Vicryl Plus) showed macroscopically fewer infections than those fixed with conventional suture, without abscesses and without dehiscence of the hernioplasty. In the microbiological quantitative bacterial study, the number of bacteria quantified per gram of sample was also lower in prostheses fixed with Vicryl Plus. Pathological analysis showed lesser colonization of the mesh and lower inflammatory response with Vicryl Plus than with normal Vicryl. In the statistical analysis, comparison of the medians of both groups and the interquartile ranges of microbial quantification revealed a lower infection rate in the Vicryl Plus group.


CONCLUSIONS
The infection rate in the surgical site can be reduced by mesh fixation using the new antimicrobial suture (Vicryl Plus). We believe that this type of suture constitutes a new weapon in the fight against postoperative infection, especially in hernioplasty, emergency surgery, and dirty or potentially contaminated surgery.
Suárez Grau
Juan Manuel
JM
Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario Virgen del Rocío, Sevilla, España. graugrau@hotmail.com
De Toro Crespo
María
M
Docobo Durántez
Fernando
F
Rubio Chaves
Carolina
C
Martín Cartes
Juan Antonio
JA
Docobo Pérez
Fernando
F
D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D059685:Herniorrhaphy; D051381:Rats; D017208:Rats, Wistar; D013203:Staphylococcal Infections / Q000382:microbiology / Q000517:prevention & control*; D013514:Surgical Procedures, Operative / Q000379:methods*; D013530:Surgical Wound Infection / Q000382:microbiology / Q000473:pathology / Q000517:prevention & control*; D013537:Sutures
D000900:Anti-Bacterial Agents