Triclosan-coated sutures do not reduce leg wound infections after coronary artery bypass grafting.
OBJECTIVE
Leg wound infection is a common complication after coronary artery bypass grafting (CABG). Suture contamination has been suggested as a mechanism of surgical site infections. Vicryl Plus(®) is a polyglacitin suture coated with the antiseptic chemical substance Triclosan, which has been shown to inhibit the growth of Staphylococcus aureus in vitro. The first aim of the present study was to compare Vicryl Plus with conventional Vicryl(®) sutures with regard to leg wound infections following CABG. The second aim was to examine patient- and operative characteristics, which are assumed to predict leg wound infections.


METHODS
After statistical calculations a priori, 328 CABG patients were prospectively randomized to leg wound closure with Vicryl Plus (164 patients) or conventional Vicryl sutures (164 patients). Incidences of leg wound infection and predictors of infection related to patient- and operative characteristics were examined.


RESULTS
The incidence of leg wound infections was 10.4% (17/163) in the Vicryl group, and 10.0% (16/160) in the Vicryl Plus group (P = 1.00). Patients with leg wound infections had increased body mass index and prolonged extracorporeal circulation and aortic clamping time compared with patients without infections.


CONCLUSIONS
In the present study, we report for the first time that Vicryl Plus did not reduce the incidence of leg wound infections in patients undergoing CABG. Obesity and prolonged time of extracorporeal circulation were both associated with the increased risk of infections. Currently, the clinical role and indication for the use of Vicryl Plus have yet to be defined.
Department of Cardiothoracic Surgery,  Oslo University Hospital, Ullevaal, Oslo,  Norway.
Bjørn Edvard
BE
Seim
Theis
T
Tønnessen
Per Reidar
PR
Woldbaek
D000891:Anti-Infective Agents, Local / Q000494:pharmacology; D020099:Coated Materials, Biocompatible; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D003324:Coronary Artery Disease / Q000601:surgery; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007866:Leg / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012501:Saphenous Vein / Q000637:transplantation; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D013548:Sweden / Q000453:epidemiology; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*; D014260:Triclosan / Q000494:pharmacology*
D000891:Anti-Infective Agents, Local; D020099:Coated Materials, Biocompatible; D014260:Triclosan