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Erfan MA, Thabet EAM, Rageh MA, Mohy SM, El Wardany I. The effect of triclosan-coated sutures on the incidence of surgical site infection in laparoscopic sleeve gastrectomy, laparoscopic appendicectomy or laparoscopic cholecystectomy: A multi-centre, double-blind, randomized, intra-individual study. Int Wound J 2024; 21:e14387. [PMID: 37705324 PMCID: PMC10784617 DOI: 10.1111/iwj.14387] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/15/2023] Open
Abstract
Surgical site infection (SSI) is a common cause of post-operative morbidity. According to the latest report announced by CDC, the SSI accounts for 20% of healthcare-associated infection with a high risk of mortality up to twofold to 11-fold increase with high economic burden for the prolonged hospital stay. Port site infection (PSI) is a subgroup of SSI occurring at the ports of laparoscopy. We tried to determine the efficacy of polyglactin 910 suture coated with triclosan in lowering the rate of PSI in some of the clean-contaminated wound surgeries. This study included 480 individuals eligible for laparoscopic cholecystectomy, appendicectomy or sleeve operations. Polyglactin 910 sutures coated with triclosan were used in one port site incision while polyglactin 910 sutures were used in the other port sites incisions. In patients who underwent laparoscopic cholecystectomy and appendicectomy, the incidence of PSI was significantly lower in the triclosan-coated sutures. In sleeve gastrectomy patients, although a lower number of triclosan-coated sutures developed PSI, there was no statistically significant difference between triclosan and non-triclosan-coated sutures. This study showed that using sutures coated with antiseptics like triclosan has clinical benefits to prevent SSIs in most of the laparoscopic surgeries.
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Affiliation(s)
- Moatasem A. Erfan
- Department of General SurgeryFaculty of Medicine, Misr University for Science and Technology (MUST)GizaEgypt
| | - El Ashraf M. Thabet
- Department of General SurgeryFaculty of Medicine, Fayoum UniversityFayoumEgypt
| | - Mahmoud A. Rageh
- Department of DermatologyFaculty of Medicine, Al‐Azhar UniversityCairoEgypt
| | - Sara M. Mohy
- Department of DermatologyFaculty of Medicine, Misr University for Science and Technology (MUST)GizaEgypt
| | - Ibrahim El Wardany
- Department of General SurgeryFaculty of Medicine, Misr University for Science and Technology (MUST)GizaEgypt
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Suleiman AS, Abbass M, Hossain M, Choudhary P, Bhattacharya P, Islam MA. Impact of antibiotic-coated sutures on surgical site infections: a second-order meta-analysis. Int J Surg 2024; 110:507-519. [PMID: 37830948 PMCID: PMC10793740 DOI: 10.1097/js9.0000000000000822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/24/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Surgical site infections (SSIs) pose a global challenge, impacting patients and healthcare expenditures. This second-order meta-analysis endeavors to assess the efficacy of antibiotic sutures in averting SSIs by amalgamating data from various meta-studies. MATERIALS AND METHODS This research adhered to the PRISMA 2020 guidelines. The quality and comprehensiveness of the encompassed meta-analyses were assessed through the QUOROM checklist and AMSTAR techniques. The primary study overlap was evaluated via measures such as pairwise intersection heat maps, corrected covered area, and the citation matrix of evidence. The statistical power at the study-level was determined utilizing the meta-meta package. Data synthesis employed random and fixed effects models at a 95% CI. A meta-regression analysis was conducted to explore potential correlations between the CDC classification of SSIs, trial types, and the observed effect sizes in the studies. RESULTS This investigation revealed a significant reduction in SSI rates due to antimicrobial-coated sutures, evidenced by a relative risk (RR) of 0.68 (95% CI: 0.59-0.76), with a prediction interval of 0.38-1.19. The analysis encompassed 18 studies with 22 meta-analyses, demonstrating a median QUOROM score of 13.6 out of 18 and an AMSTAR score of 9.1 out of 11. The presence of moderate heterogeneity was noted ( Q =106.611, I2 =54.038%), with nonrandomized controlled trials exhibiting an RR of 0.56 (95% CI: 0.39-0.80), and RCTs displaying an RR of 0.71 (95% CI: 0.63-0.81). Subgroup analysis unveiled variable RR reductions for specific surgical procedures. CONCLUSION Antimicrobial-coated sutures offer a promising approach to mitigating SSIs risk. However, their efficacy is optimally realized when employed in conjunction with other robust practices.
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Affiliation(s)
- Adeiza S. Suleiman
- Department of Pharmaceutical Microbiology, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Kaduna, Nigeria
| | - Mortada Abbass
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon
| | - Maqsud Hossain
- University of Nottingham, Sutton Bonington Campus, Loughborough, Leicestershire, UK
| | - Priyanka Choudhary
- Department of Veterinary Microbiology, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Rampura Phul, Bathinda, Punjab, India
- Advanced Molecular Lab, Department of Microbiology, President Abdul Hamid Medical College, Karimganj 2310, Bangladesh
| | - Prosun Bhattacharya
- Corresponding author. Address: Department of Microbiology, President Abdul Hamid Medical College Hospital, Kishoreganj (PAHMCH) Senior Research Assistant, NSTU COVID-19 Lab, Noakhali, Bangladesh. Tel.: +91 9871608125. E-mail: (M.A. Islam); Department of Clinical Pharmacy and Pharmacy Practice, Faculty Pharmaceutical Science, UDUS. Tel.: +91 9871608125. E-mail: (S.S. Adeiza)
| | - Md. Aminul Islam
- Advanced Molecular Lab, Department of Microbiology, President Abdul Hamid Medical College, Karimganj 2310, Bangladesh
- COVID-19 Diagnostic lab, Department of Microbiology, Noakhali Science and Technology University, Noakhali 3814, Bangladesh
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Bustamante Montalvo M, Cainzos M, Prieto Carreiras L, Castiñeira Piñeiro A, García Iglesias A, Fernandez Novo A, González Gómez LM, Flores A, Diz Gil R, Fernández Baltar C. Evaluation of the effect of triclosan coated sutures in the prevention of surgical site infections in a Spanish hospital setting: A prospective, observational study. Infect Prev Pract 2021; 3:100154. [PMID: 34430841 PMCID: PMC8365457 DOI: 10.1016/j.infpip.2021.100154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 06/01/2021] [Indexed: 01/27/2023] Open
Abstract
Background Surgical site infections (SSIs) are one of the most frequently reported types of hospital-acquired infection and are associated with substantial clinical and economic burden. Aim To assess the incidence of SSIs and analyze contributing risk factors in a real-world Spanish hospital setting before and after the implementation of triclosan-coated sutures (TCS). Methods A prospective, observational study was conducted at Hospital Clínico Universitario de Santiago de Compostela, Spain. Enrolled patients underwent surgery in the following specialties: general surgery, urology, neurosurgery, gynaecology, and traumatology. The primary outcome of the study was SSI incidence, assessed at a 30-day follow-up. Secondary outcomes were length of hospital stay, and readmission, reintervention, and mortality rates, also at 30 days. Findings 5,081 patients were included in the study, of which 2,591 were treated using non-coated sutures (NCS) and 2,490 using TCS. After adjusting for potential confounders, TCS significantly reduced SSI rate by 36%, compared with NCS (odds ratio [OR]: 0.64; 95% confidence interval [CI]: 0.48-0.85; P<0.003). When stratified by wound classification, a statistically significant reduction in SSI incidence, in favour of TCS use, was observed for Class IV (dirty) wounds (35.6% versus 22.7% for NCS and TCS, respectively; OR: 0.53; 95% CI: 0.31-0.90). Conclusion The use of TCS reduced SSI risk when compared with NCS. This reduction was significant for Class IV wounds, providing evidence that supports the use of TCS for this type of wound.
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Affiliation(s)
- Manuel Bustamante Montalvo
- Servicio de Cirugía General y Digestiva, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Miguel Cainzos
- Servicio de Cirugía General y Digestiva, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Luis Prieto Carreiras
- Servicio de Cirugía General y Digestiva, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Andrea Castiñeira Piñeiro
- Servicio de Cirugía General y Digestiva, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Adrián García Iglesias
- Servicio de Traumatología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Ana Fernandez Novo
- Servicio de Ginecología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Lara María González Gómez
- Servicio de Neurocirugía, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Ana Flores
- Servicio de Neurocirugía, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Rita Diz Gil
- Servicio de Urología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Carlos Fernández Baltar
- Servicio de Urología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
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Matz D, Teuteberg S, Wiencierz A, Soysal SD, Heizmann O. Do antibacterial skin sutures reduce surgical site infections after elective open abdominal surgery? - Study protocol of a prospective, randomized controlled single center trial. Trials 2019; 20:390. [PMID: 31266520 PMCID: PMC6604458 DOI: 10.1186/s13063-019-3492-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 06/05/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Surgical site infections (SSI) remain one of the most common complications in conventional abdominal surgery with an incidence between 4% and 19% (Sandini et al., Medicine (Baltimore) 95:e4057, 2016) in the literature. It is unclear whether the use of coated suture material for skin closure reduces the risk of SSI. In line with in-vitro results, we hypothesize that the use of antibacterial skin sutures (triclosan-coated poliglecaprone 25) reduces the rate of SSI after open abdominal surgery. METHODS/DESIGN To prevent SSI, triclosan-coated poliglecaprone 25 sutures will be tested against un-coated suture material for skin closure after elective open abdominal surgery of 364 patients. The study is planned as a single-center, prospective randomized controlled trial. Patients will be followed for 30 days after surgery to detect and document wound complications. The rate of SSI after 30 days will be analyzed in both groups. DISCUSSION If we can confirm the proposed hypothesis in our study, this could be a promising and feasible approach to lower SSI after open abdominal surgery. By lowering the rate of SSI this might offer a cost-saving and morbidity-reducing procedure. TRIAL REGISTRATION German Clinical Trials Register, DRKS00010047 . Registered on 05.01.2017.
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Affiliation(s)
- Daniel Matz
- Department of General-, Visceral- and Thoracic Surgery, AGAPLESION Diakonie Hospital Rotenburg (Wuemme), Elise Averdieck-Str. 17, 27356, Rotenburg (Wuemme), Germany.
| | - Saskia Teuteberg
- Department of General-, Visceral- and Thoracic Surgery, AGAPLESION Diakonie Hospital Rotenburg (Wuemme), Elise Averdieck-Str. 17, 27356, Rotenburg (Wuemme), Germany
| | - Andrea Wiencierz
- Department of Clinical Research, University of Basel, Clinical Trial Unit, University Hospital, Spitalstrasse 12, 4031, Basel, Switzerland
| | - Savas Deniz Soysal
- Department of General Surgery, University of Basel Hospital, Spitalstrasse 21, 4031, Basel, Switzerland
| | - Oleg Heizmann
- Department of General-, Visceral- and Thoracic Surgery, AGAPLESION Diakonie Hospital Rotenburg (Wuemme), Elise Averdieck-Str. 17, 27356, Rotenburg (Wuemme), Germany.,Department of General Surgery, University of Basel Hospital, Spitalstrasse 21, 4031, Basel, Switzerland
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Thambirajah AA, Koide EM, Imbery JJ, Helbing CC. Contaminant and Environmental Influences on Thyroid Hormone Action in Amphibian Metamorphosis. Front Endocrinol (Lausanne) 2019; 10:276. [PMID: 31156547 PMCID: PMC6530347 DOI: 10.3389/fendo.2019.00276] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 04/16/2019] [Indexed: 12/31/2022] Open
Abstract
Aquatic and terrestrial environments are increasingly contaminated by anthropogenic sources that include pharmaceuticals, personal care products, and industrial and agricultural chemicals (i. e., pesticides). Many of these substances have the potential to disrupt endocrine function, yet their effect on thyroid hormone (TH) action has garnered relatively little attention. Anuran postembryonic metamorphosis is strictly dependent on TH and perturbation of this process can serve as a sensitive barometer for the detection and mechanistic elucidation of TH disrupting activities of chemical contaminants and their complex mixtures. The ecological threats posed by these contaminants are further exacerbated by changing environmental conditions such as temperature, photoperiod, pond drying, food restriction, and ultraviolet radiation. We review the current knowledge of several chemical and environmental factors that disrupt TH-dependent metamorphosis in amphibian tadpoles as assessed by morphological, thyroid histology, behavioral, and molecular endpoints. Although the molecular mechanisms for TH disruption have yet to be determined for many chemical and environmental factors, several affect TH synthesis, transport or metabolism with subsequent downstream effects. As molecular dysfunction typically precedes phenotypic or histological pathologies, sensitive assays that detect changes in transcript, protein, or metabolite abundance are indispensable for the timely detection of TH disruption. The emergence and application of 'omics techniques-genomics, transcriptomics, proteomics, metabolomics, and epigenomics-on metamorphosing tadpoles are powerful emerging assets for the rapid, proxy assessment of toxicant or environmental damage for all vertebrates including humans. Moreover, these highly informative 'omics techniques will complement morphological, behavioral, and histological assessments, thereby providing a comprehensive understanding of how TH-dependent signal disruption is propagated by environmental contaminants and factors.
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Affiliation(s)
| | | | | | - Caren C. Helbing
- Department of Biochemistry and Microbiology, University of Victoria, Victoria, BC, Canada
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