title: Triclosan-coated sutures reduce wound infections after spinal surgery: a retrospective, nonrandomized, clinical study.
abstract: BACKGROUND
  Surgical site infection (SSI) is a serious postoperative complication. The incidence of SSIs is lower in clean orthopedic surgery than in other fields, but it is higher after spinal surgery, reaching 4.15% in high-risk patients. Several studies reported that triclosan-coated polyglactin 910 sutures (Vicryl Plus; Ethicon, Inc., Somerville, NJ, USA) significantly reduced the infection rate in the general surgical, neurosurgical, and thoracic surgical fields. However, there have been no studies on the effects of such coated sutures on the incidence of SSIs in orthopedics.
  
  
  OBJECTIVE
  To compare the incidence of wound infections after spinal surgery using triclosan-coated suture materials with that of noncoated ones.
  
  
  METHODS
  A retrospective, nonrandomized, and clinical study.
  
  
  METHODS
  From May 2010 to April 2012, 405 patients underwent a spinal surgical procedure in the Department of Orthopedic Surgery of two university hospitals.
  
  
  METHODS
  The primary outcome was the number of wound infections and dehiscences.
  
  
  METHODS
  Two hundred five patients had a conventional wound closure with polyglactin 910 suture (Vicryl) between May 2010 and April 2011 (Time Period 1 [TP1]), and 200 patients underwent wound closure with triclosan-coated polyglactin 910 suture (Vicryl Plus) between May 2011 and April 2012 (TP2). Statistical comparisons of wound infections, dehiscence, and risk factors for poor wound healing or infection were performed. None of the authors has any conflict of interest associated with this study.
  
  
  RESULTS
  There were two cases of wound dehiscence in TP1 and one in TP2 (p=.509). Using noncoated sutures in TP1, eight patients (3.90%) had wound infections, whereas one patient (0.50%) had wound infections in TP2 (using triclosan-coated sutures); the difference was significant (p=.020).
  
  
  CONCLUSIONS
  The use of triclosan-coated polyglactin 910 sutures instead of polyglactin 910 sutures may reduce the number of wound infections after spinal surgery.
authors.affiliation: Department of Orthopaedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 252-0373, Japan. Electronic address: masaki.ueno00@gmail.com.
authors.forename: Masaki
authors.initials: M
authors.lastname: Ueno
authors.affiliation: Department of Orthopaedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 252-0373, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Saito
authors.affiliation: Department of Nursing, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami, Sagamihara, Kanagawa 252-0380, Japan.
authors.forename: Megumu
authors.initials: M
authors.lastname: Yamagata
authors.affiliation: Department of Orthopaedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 252-0373, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Imura
authors.affiliation: Department of Orthopaedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 252-0373, Japan.
authors.forename: Gen
authors.initials: G
authors.lastname: Inoue
authors.affiliation: Department of Orthopaedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 252-0373, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Nakazawa
authors.affiliation: Department of Rehabilitation, Kitasato University School of Allied Health Sciences, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 252-0373, Japan.
authors.forename: Naonobu
authors.initials: N
authors.lastname: Takahira
authors.affiliation: Department of Orthopaedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 252-0373, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Uchida
authors.affiliation: Department of Nursing, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami, Sagamihara, Kanagawa 252-0380, Japan.
authors.forename: Nobuko
authors.initials: N
authors.lastname: Fukahori
authors.affiliation: Department of Nursing, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami, Sagamihara, Kanagawa 252-0380, Japan.
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Shimomura
authors.affiliation: Department of Orthopaedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 252-0373, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Takaso
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011098:Polyglactin 910 / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D013124:Spinal Injuries / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology*; D013537:Sutures / Q000009:adverse effects*; D014260:Triclosan / Q000009:adverse effects*; D014946:Wound Infection / Q000517:prevention & control
chemical_list: D011098:Polyglactin 910; D014260:Triclosan
keywords: Antimicrobial suture; Spinal surgery; Surgical site infection; Triclosan; Wound closure