[Comparison of wound infection rates after colon and rectal surgeries using triclosan-coated or bare sutures -- a multi-center, randomized clinical study].
BACKGROUND
Surgical Site Infection (SSI) is the third most frequent nosocomial infection, and accounts for 14-16% of all infections. While the treatment of SSI can be very costly, previous results indicated that triclosan may reduce SSI rate. Therefore, we carried out a prospective randomised trial to further evaluate the effect of triclosan after elective colorectal surgery.


METHODS
Seven surgical units in Hungary were involved in a prospective, randomised, multicentric clinical trial to compare triclosan coated (PDS plus®) and uncoated (PDS II®) sutures for abdominal wall closure in elective colorectal surgery. Pre- and perioperative variables were recorded in an online database. The primary aims of the study were to determine the incidence of SSI and the pathogens associated with it, as well as evaluation of additional cost of treatment.


RESULTS
485 patients were randomised. SSI occurred in 47 cases (12.5%), of those 23 (12.23%) from the triclosan group (n = 188) and 24 (12.18%) from the uncoated group (n = 197, p = 0.982). In 13 (27.66%) cases late appearance of SSI was detected, of those 4 patients with triclosan coated suture (8.51%) and 9 patients with uncoated suture (19.15%, p = 0.041). There was no difference between the type of incisions or elective colon and rectal resections in terms of incidence of SSI.


CONCLUSIONS
Beneficial effect of triclosan against Gram positive bacteria could not be confirmed in our study due to the relatively low number of patients with SSI. Furthermore, triclosan did not influence the incidence of SSI due to Gram negative bacteria. SSI rate decreased by 50% compared to our previous study, however, it was regardless of the use of coated or uncoated PDS loop. Finally, operative factors were more important than patient's risk factors in terms of incidence of SSI. In case SSI developed, delayed discharge from hospital as well as special wound care significantly increased overall cost of treatment.
Pécsi Tudományegyetem Klinikai Központ Sebészeti Klinika 7624 Pécs Rákóczi u. 2. o.huszar@gmail.com
Orsolya
O
Huszár
József
J
Baracs
Mariann
M
Tóth
László
L
Damjanovich
Róbert
R
Kotán
György
G
Lázár
Eszter
E
Mán
Gellért
G
Baradnai
Attila
A
Oláh
Zoltán
Z
Benedek-Tóth
Sándor
S
Bogdán-Rajcs
Péter
P
Zemanek
Tibor
T
Oláh
Krisztián
K
Somodi
Mihály
M
Svébis
Tamás
T
Molnár
Örs Péter
ÖP
Horváth
D000368:Aged; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D003108:Colonic Diseases / Q000601:surgery*; D003107:Colorectal Surgery / Q000379:methods*; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012002:Rectal Diseases / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology; D013537:Sutures; D016896:Treatment Outcome; D014260:Triclosan / Q000627:therapeutic use*
D000891:Anti-Infective Agents, Local; D014260:Triclosan