title: Cosmetic outcome and surgical site infection rates of antibacterial absorbable (Polyglactin 910) suture compared to Chinese silk suture in breast cancer surgery: a randomized pilot research.
abstract: BACKGROUND
  The primary objective of this multicenter post-market study was to compare the cosmetic outcome of triclosan-coated VICRYL Plus sutures with Chinese silk sutures for skin closure of modified radical mastectomy. A secondary objective was to assess the incidence of surgical site infection (SSI).
  
  
  METHODS
  Patients undergoing modified radical mastectomy were randomly assigned to coated VICRYL Plus antibacterial (Polyglactin 910) suture or Chinese silk suture. Cosmetic outcomes were evaluated postoperatively at days 12 (± 2) and 30 (± 5), and the evidence of SSI was assessed at days 3, 5, 7, 12 (± 2), 30 (± 5), and 90 (± 7). Cosmetic outcomes were independently assessed via visual analogue scale (VAS) score evaluations of blinded incision photographs (primary endpoint) and surgeon-assessed modified Hollander Scale (mHCS) scores (secondary endpoint). SSI assessments used both CDC criteria and ASEPSIS scores.
  
  
  RESULTS
  Six Chinese hospitals randomized 101 women undergoing modified radical mastectomy to closure with coated VICRYL Plus suture (n = 51) or Chinese silk suture (n = 50). Mean VAS cosmetic outcome scores for antibacterial suture (67.2) were better than for Chinese silk (45.4) at day 30 (P < 0.0001)). Mean mHCS cosmetic outcome total scores, were also higher for antibacterial suture (5.7) than for Chinese silk (5.0) at day 30 (P = 0.002).
  
  
  CONCLUSIONS
  Patients using coated VICRYL Plus suture had significantly better cosmetic outcomes than those with Chinese silk sutures. Patients using coated VICRYL Plus suture had a lower SSI incidence compared to the Chinese silk sutures, although the difference did not reach statistical significance.
authors.affiliation: Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China. zhangzht@medmail.com.cn
authors.forename: Zhong-Tao
authors.initials: ZT
authors.lastname: Zhang
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Zhang
authors.forename: Xue-Dong
authors.initials: XD
authors.lastname: Fang
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Wang
authors.forename: Xiao-Xi
authors.initials: XX
authors.lastname: Li
authors.forename: Ya-Fen
authors.initials: YF
authors.lastname: Li
authors.forename: Xiao-Wei
authors.initials: XW
authors.lastname: Sun
authors.forename: Judith
authors.initials: J
authors.lastname: Carver
authors.forename: Dorella
authors.initials: D
authors.lastname: Simpkins
authors.forename: Jessica
authors.initials: J
authors.lastname: Shen
authors.forename: Martin
authors.initials: M
authors.lastname: Weisberg
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000009:adverse effects; D011098:Polyglactin 910 / Q000627:therapeutic use*; D047011:Silk / Q000627:therapeutic use*; D013530:Surgical Wound Infection / Q000382:microbiology*; D013537:Sutures; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D047011:Silk; D011098:Polyglactin 910