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European Journal of Clinical Microbiology & Infectious Diseases

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01-01-2017 | Original Article

Antimicrobial-coated sutures to decrease surgical site infections: a systematic review and meta-analysis

Authors: X. Wu, N. Z. Kubilay, J. Ren, B. Allegranzi, P. Bischoff, B. Zayed, D. Pittet, J. Li

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 1/2017

Abstract

To investigate the effectiveness of antimicrobial-coated sutures compared with non-coated sutures in reducing surgical site infection (SSI) and develop recommendations for World Health Organization (WHO) SSI prevention guidelines. We searched Medline, Embase, Cinahl, Cochrane Central Register of Controlled Trials, and WHO Global Health from 1990–16/02/2015 with language restricted to English, Spanish, and French. Meta-analysis was performed with a random-effects model. Meta-regression analysis assessed whether the effect of antimicrobial coating changed according to the type of suture and surgery. Subgroup analyses were based on types of sutures. Quality of the retrieved evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation. Thirteen randomized controlled trials (RCTs) and five observational studies (OBSs) met the inclusion criteria. Antimicrobial sutures significantly reduced SSI risk (for RCTs: OR 0.72, 95 % CI 0.59–0.88, p = 0.001, I² = 14 %; for OBSs: OR 0.58, 95 % CI 0.40–0.83, p = 0.003, I² = 22 %). Only Vicryl Plus vs Vicryl revealed consistent results in favor of antimicrobial sutures (for seven RCTs: OR 0.62, 95 % CI 0.44–0.88, p = 0.007, I² = 3 %; for four OBSs: OR 0.58, 95 % CI 0.37–0.92, p = 0.02, I² = 41 %). The effect of antimicrobial coating was similar between different suture, wound, and procedure types. Quality of RCT evidence was moderate, and OBS evidence was very low quality. Triclosan-coated sutures may reduce SSI risk. However, the available evidence is of moderate/low quality, and many studies had conflicts of interest.

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Title: Antimicrobial-coated sutures to decrease surgical site infections: a systematic review and meta-analysis
Authors: X. Wu
N. Z. Kubilay
J. Ren
B. Allegranzi
P. Bischoff
B. Zayed
D. Pittet
J. Li
Publication date: 01-01-2017
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Clinical Microbiology & Infectious Diseases / Issue 1/2017
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI: https://doi.org/10.1007/s10096-016-2765-y

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