title: Surgical-site infection after abdominal wall closure with triclosan-impregnated polydioxanone sutures: results of a randomized clinical pathway facilitated trial (NCT00998907).
abstract: BACKGROUND
  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 prevent the contamination of suture material in surgical wounds, triclosan-coated suture materials with antibacterial activity was developed. We here report a prospective randomized pathway controlled trial investigating the effect of triclosan impregnation of polydioxanone sutures used for abdominal wall closure on the rate of surgical-site infections.
  
  
  METHODS
  A total of 856 patients included in this trial underwent a standardized clinical pathway documented abdominal wall closure after abdominal surgery. Patients were randomized to have the fascia closed with either a 2-0 polydioxanone loop or a triclosan impregnated 2-0 polydioxanone loop. The primary outcome was the number of wound infections. Risk factors for poor wound healing were collected prospectively to compare the two groups.
  
  
  RESULTS
  When a PDS loop suture for abdominal wall closure was used, 42 (11.3%) patients with wound infections were detected. The number of patients with wound infections decreased significantly to 31 when the PDS plus for abdominal wall closure was used (6.4%, P < .05). Other risk factors for the development of side infections were comparably in the two groups.
  
  
  CONCLUSIONS
  This clinical pathway facilitated trial shows that triclosan impregnation of a 2-0 polydioxanone closing suture can decrease wound infections in patients having a laparotomy for general and abdominal vascular procedures.
authors.affiliation: Department of General and Visceral Surgery, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Justinger
authors.forename: Jan Erik
authors.initials: JE
authors.lastname: Slotta
authors.forename: Sebastian
authors.initials: S
authors.lastname: Ningel
authors.forename: Stefan
authors.initials: S
authors.lastname: Gräber
authors.forename: Otto
authors.initials: O
authors.lastname: Kollmar
authors.forename: Martin Karl
authors.initials: MK
authors.lastname: Schilling
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016687:Polydioxanone; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D013537:Sutures; D014260:Triclosan / Q000008:administration & dosage*
chemical_list: D000891:Anti-Infective Agents, Local; D016687:Polydioxanone; D014260:Triclosan