title: Triclosan-containing sutures versus ordinary sutures for reducing surgical site infections in children: a double-blind, randomised controlled trial.
abstract: Surgical site infections (SSIs) are a pervasive problem in surgery. Sutures coated or impregnated with triclosan might reduce the occurrence of SSIs, but evidence of their efficacy is limited, especially in children.
  
  
  
  We designed a randomised, double-blind, controlled trial in patients who underwent elective or daytime emergency surgery at Oulu University Hospital (Oulu, Finland). We included children younger than 18 years staying in the paediatric surgery and orthopaedics ward for any elective or emergency surgery during the daytime and with anticipated use of absorbing sutures. Children were randomly allocated (1:1) to receive either triclosan-containing sutures or ordinary absorbing sutures. The primary outcome was the occurrence of superficial or deep surgical site infections according to the Centers for Disease Control and Prevention criteria within 30 days after surgery. The primary analysis was with modified intention to treat. This trial is registered at ClinicalTrials.gov, number NCT01220700.
  
  
  
  Between September, 2010, and December, 2014, 1633 children were recruited. In the modified intention-to-treat group, SSIs occurred in 20 (3%) of 778 patients allocated to receive triclosan-containing sutures and in 42 (5%) of 779 patients allocated to receive control sutures (risk ratio 0·48, 95% CI 0·28-0·80). To prevent one SSI, triclosan-containing sutures had to be used in 36 children (95% CI 21-111). One patient died from suspected mitochondrial disease; no other expected or unexpected adverse events were reported in either of the groups.
  
  
  
  Use of triclosan-containing sutures effectively reduced the occurrence of all SSIs compared with normal sutures. The results accord with the results of meta-analyses of previous studies in adults. Use of triclosan-containing sutures is a simple way to reduce SSIs in children.
  
  
  
  The Alma and K A Snellman Foundation.
authors.affiliation: PEDEGO Research Unit, Medical Research Centre, University of Oulu, Oulu, Finland; Oulu University Hospital, Department of Children and Adolescents, Oulu, Finland. Electronic address: marjo.renko@oulu.fi.
authors.forename: Marjo
authors.initials: M
authors.lastname: Renko
authors.affiliation: PEDEGO Research Unit, Medical Research Centre, University of Oulu, Oulu, Finland; Oulu University Hospital, Department of Children and Adolescents, Oulu, Finland.
authors.forename: Niko
authors.initials: N
authors.lastname: Paalanne
authors.affiliation: PEDEGO Research Unit, Medical Research Centre, University of Oulu, Oulu, Finland; Oulu University Hospital, Department of Children and Adolescents, Oulu, Finland.
authors.forename: Terhi
authors.initials: T
authors.lastname: Tapiainen
authors.affiliation: PEDEGO Research Unit, Medical Research Centre, University of Oulu, Oulu, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Hinkkainen
authors.affiliation: Oulu University Hospital, Department of Children and Adolescents, Oulu, Finland.
authors.forename: Tytti
authors.initials: T
authors.lastname: Pokka
authors.affiliation: PEDEGO Research Unit, Medical Research Centre, University of Oulu, Oulu, Finland; Oulu University Hospital, Department of Children and Adolescents, Oulu, Finland.
authors.forename: Sohvi
authors.initials: S
authors.lastname: Kinnula
authors.affiliation: PEDEGO Research Unit, Medical Research Centre, University of Oulu, Oulu, Finland; Oulu University Hospital, Department of Children and Adolescents, Oulu, Finland.
authors.forename: Juha-Jaakko
authors.initials: JJ
authors.lastname: Sinikumpu
authors.affiliation: PEDEGO Research Unit, Medical Research Centre, University of Oulu, Oulu, Finland; Oulu University Hospital, Department of Children and Adolescents, Oulu, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Uhari
authors.affiliation: PEDEGO Research Unit, Medical Research Centre, University of Oulu, Oulu, Finland; Oulu University Hospital, Department of Children and Adolescents, Oulu, Finland.
authors.forename: Willy
authors.initials: W
authors.lastname: Serlo
mesh_terms: D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005387:Finland; D006801:Humans; D013530:Surgical Wound Infection / Q000517:prevention & control*; D013537:Sutures; D014260:Triclosan / Q000008:administration & dosage*
chemical_list: D000891:Anti-Infective Agents, Local; D014260:Triclosan