title: Triclosan-coated sutures reduce wound infections after hepatobiliary surgery--a prospective non-randomized clinical pathway driven study.
abstract: OBJECTIVE
  Wound infections after abdominal surgery are still frequent types of nosocomial infections. Suture materials might serve as a vehicle for mechanical transport of bacteria into the surgical wound. To reduce bacterial adherence to surgical sutures, triclosan-coated polyglactin 910 suture materials with antiseptic activity (Vicryl plus®) were developed. The aim of this prospective non-randomized clinical pathway driven study was to ascertain if the use of Vicryl plus® reduced the number of wound infections after transverse laparotomy.
  
  
  METHODS
  Between October 2003 and October 2007, 839 operations were performed using a transverse abdominal incision. In the first time period, a PDSII® loop suture was used for abdominal wall closure. In the second time period, we used Vicryl plus®. Risk factors were collected prospectively to compare the two groups.
  
  
  RESULTS
  Using a PDSII® loop suture for abdominal wall closure in the first time period, 9.2% of the patients developed wound infections. In the second time period, using Vicryl plus®, the number of wound infections decreased to 4.3% (p < 0,005). Both groups were comparable regarding risk factors despite no other changes in protocols of patient care.
  
  
  CONCLUSIONS
  Antiseptic-coated loop Vicryl suture for abdominal wall closure can be superior to PDSII sutures in respect to the development of wound infections after a two-layered closure of transverse laparotomy.
authors: Department of General, Visceral, Vascular and Pediatric Surgery, University of Saarland, 66421 Homburg/Saar, Germany. christoph.justinger@uks.eu
authors: Christoph
authors: C
authors: Justinger
authors: Jochen
authors: J
authors: Schuld
authors: Jens
authors: J
authors: Sperling
authors: Otto
authors: O
authors: Kollmar
authors: Sven
authors: S
authors: Richter
authors: Martin Karl
authors: MK
authors: Schilling
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000891:Anti-Infective Agents, Local / Q000494:pharmacology*; D019072:Antibiotic Prophylaxis; D019091:Critical Pathways; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011098:Polyglactin 910; D011446:Prospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013530:Surgical Wound Infection / Q000517:prevention & control*; D013537:Sutures; D016896:Treatment Outcome; D014260:Triclosan / Q000494:pharmacology*
chemical_list: D000891:Anti-Infective Agents, Local; D011098:Polyglactin 910; D014260:Triclosan