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International Journal of Colorectal Disease

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01-10-2018 | Original Article

Effect of triclosan-coated sutures on surgical site infections in pilonidal disease: prospective randomized study

Authors: Naciye Cigdem Arslan, Gulsen Atasoy, Tansu Altintas, Cem Terzi

Published in: International Journal of Colorectal Disease | Issue 10/2018

Abstract

Purpose

The aim of this study is to investigate the effect of triclosan-coated sutures on surgical site infections after wide excision and primary closure for pilonidal disease.

Methods

One hundred seventy-seven patients were randomized into two groups: 91 in control and 86 in triclosan groups. In the control group, 1/0 monofilament polypropylene retention sutures, 3/0 polyglactin subcutaneous sutures, and 3/0 polypropylene skin sutures were used. In the triclosan group, 1/0 triclosan-coated monofilament polydioxanone, 3/0 triclosan-coated polyglactin, and 3/0 triclosan-coated monofilament polydioxanone were used. Postoperative care and follow-up was made by a surgeon according to Centers for Disease Control guideline. Surgical site infection rates between groups were compared. Secondary outcomes were seroma and wound dehiscence.

Results

Seroma was seen in 30 (16.9%) patients: 20 (23.3%) in the triclosan group and 10 (10.9%) in the control group (p = 0.030). Thirteen (7.3%) patients had superficial wound dehiscence: 5 (5.5%) patients in the control group and 10 (11.6%) patients in the triclosan group (p = 0.116). Overall surgical site infection (SSI) rate was 15.8% (n = 28): 19 (20.8%) patients in the control group and 9 (10.5%) patients in the triclosan group (p = 0.044). Healing was observed on mean 17.8 ± 6.7 days. Primary and secondary healing rates and time to healing were similar between groups.

Conclusion

Triclosan-coated sutures decreased surgical site infection rate but had no effect on time to healing in pilonidal disease. Seroma and wound dehiscence were more common in triclosan groups. Randomized trials are needed to clear the effect of triclosan-coated sutures on postoperative wound complications.

Stauffer VK, Luedi MM, Kauf P, Schmid M, Diekmann M, Wieferich K, Schnüriger B, Doll D (2018) Common surgical procedures in pilonidal sinus disease: a meta-analysis, merged data analysis, and comprehensive study on recurrence. Sci Rep 8(1):1–28CrossRef

Lo JJ, Cooper JN, Halleran DR, Deans KJ, Minneci PC (2018) High rate of major morbidity after surgical excision for pilonidal disease. 19(X):1–5

Petersen S, Koch R, Stelzner S, Wendlandt T-P, Ludwig K (2002) Primary closure techniques in chronic pilonidal sinus: a survey of the results of different surgical approaches. Dis Colon Rectum 45(11):1458–1467CrossRefPubMed

Fahrni GT, Vuille-Dit-Bille RN, Leu S, Meuli M, Staerkle RF, Fink L, Dinçler S, Muff BS (2016) Five-year follow-up and recurrence rates following surgery for acute and chronic pilonidal disease: a survey of 421 cases. Wounds 28(1):20–26PubMed

O’Hara LM, Thom KA, Preas MA (2018) Update to the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee guideline for the prevention of surgical site infection (2017): a summary, review, and strategies for implementation. Am J Infect Control 46(6):602–609CrossRefPubMed

Guo J, Pan LH, Li YX, Di Yang X, Li LQ, Zhang CY, Zhong JH (2016) Efficacy of triclosan-coated sutures for reducing risk of surgical site infection in adults: a meta-analysis of randomized clinical trials. J Surg Res 201(1):105–117CrossRefPubMed

Sandini M, Mattavelli I, Nespoli L, Uggeri F, Gianotti L (2016) Systematic review and meta-analysis of sutures coated with triclosan for the prevention of surgical site infection after elective colorectal surgery according to the PRISMA statement. Medicine 95:35CrossRef

Sprowson AP, Jensen C, Parsons N, Partington P, Emmerson K, Carluke I, Asaad S, Pratt R, Muller S, Ahmed I, Reed MR (2018) The effect of triclosan-coated sutures on the rate of surgical site infection after hip and knee arthroplasty: a double-blind randomized controlled trial of 2546 patients. Bone Jt J 100B(3):296–302CrossRef

Karip AB, Çelik K, Aydın T, Yazıcılar H, İşcan Y, Ağalar C, Memişoğlu K (2016) Effect of triclosan-coated suture and antibiotic prophylaxis on infection and recurrence after Karydakis flap repair for pilonidal disease: a randomized parallel-arm double-blinded clinical trial. Surg Infect 17(5):583–588CrossRef

10.

Leaper DJ, Edmiston CE, Holy CE (2017) Meta-analysis of the potential economic impact following introduction of absorbable antimicrobial sutures. Br J Surg 104(2):e134–e144CrossRefPubMed

11.

Daoud FC, Edmiston CE, Leaper D (2014) Meta-analysis of prevention of surgical site infections following incision closure with triclosan-coated sutures: robustness to new evidence. Surg Infect 15(3):165–181CrossRef

12.

de Jonge SW, Atema JJ, Solomkin JS, Boermeester MA (2017) Meta-analysis and trial sequential analysis of triclosan-coated sutures for the prevention of surgical-site infection. Br J Surg 104(2):e118–e133CrossRefPubMed

13.

Quinodoz PD, Chilcott M, Grolleau JL, Chavoin JP, Costagliola M (1999) Surgical treatment of sacrococcygeal pilonidal sinus disease by excision and skin flaps: the Toulouse experience. Eur J Surg 165(11):1061–1065CrossRefPubMed

14.

Clothier PR, Haywood IR (1984) The natural history of the post anal (pilonidal) sinus. Ann R Coll Surg Engl 66(3):201–203PubMedPubMedCentral

15.

Emiroǧlu M, Karaali C, Esin H, Akpinar G, Aydin C (2017) Treatment of pilonidal disease by phenol application. Turkish J Surg 33(1):5–9CrossRef

16.

Karakas E, Steinfeldt T, Gockel A, Mangalo A, Sesterhenn A, Bartsch DK (2014) Transoral parathyroid surgery—a new alternative or nonsense? Langenbeck's Arch Surg 399(6):741–745CrossRef

17.

Mutus HM, Aksu B, Uzun E, Gulcin N, Gercel G, Ozatman E, Durakbasa CU, Okur H (2018) Long-term analysis of surgical treatment outcomes in chronic pilonidal sinus disease. J Pediatr Surg 53(2):293–294CrossRefPubMed

18.

Kuckelman JP (2018) Pilonidal disease: management and definitive treatment. Dis Colon Rectum 61(7):775–777PubMed

19.

Al-Khayat H, Al-Khayat H, Sadeq A, Groof A, Haider HH, Hayati H, Shamsah A, Zarka ZA, Al-Hajj H, Al-Momen A (2007) Risk factors for wound complication in pilonidal sinus procedures. J Am Coll Surg 205(3):439–444CrossRefPubMed

20.

Diener MK, Knebel P, Kieser M, Schüler P, Schiergens TS, Atanassov V, Neudecker J, Stein E, Thielemann H, Kunz R, Von Frankenberg M, Schernikau U, Bunse J, Jansen-Winkeln B, Partecke LI, Prechtl G, Pochhammer J, Bouchard R, Hodina R, Beckurts KTE, Leißner L, Lemmens HP, Kallinowski F, Thomusch O, Seehofer D, Simon T, Hyhlik-Dürr A, Seiler CM, Hackert T, Reissfelder C, Hennig R, Doerr-Harim C, Klose C, Ulrich A, Büchler MW (2014) Effectiveness of triclosan-coated PDS plus versus uncoated PDS II sutures for prevention of surgical site infection after abdominal wall closure: the randomised controlled PROUD trial. Lancet 384(9938):142–152CrossRefPubMed

21.

Sewefy AM, Hassanen A, Atyia AM, Saleh SK (2017) Karydakis flap with compressing tie-over interrupted sutures without drain versus standard karydakis for treatment of sacrococcygeal pilonidal sinus disease. Dis Colon Rectum 60(5):514–520CrossRefPubMed

22.

Karydakis GE (1992) Easy and successful treatment of pilonidal sinus after explanation of its causative process. Aust N Z J Surg 62(5):385–389CrossRefPubMed

23.

Terzi C, Canda AE, Unek T, Dalgic E, Fuzun M (2005) What is the role of mechanical bowel preparation in patients with pilonidal sinus undergoing surgery? Prospective, randomized, surgeon-blinded trial. World J Surg 29(11):1465–1471CrossRefPubMed

24.

Wu X, Kubilay NZ, Ren J, Allegranzi B, Bischoff P, Zayed B, Pittet D, Li J (2017) Antimicrobial-coated sutures to decrease surgical site infections: a systematic review and meta-analysis. Eur J Clin Microbiol Infect Dis 36(1):19–32CrossRefPubMed

25.

Rothenburger S, Spangler D, Bhende S, Burkley D (2002) In vitro antimicrobial evaluation of coated VICRYL* plus antibacterial suture (coated Polyglactin 910 with triclosan) using zone of inhibition assays. Surg Infect 3(Suppl 1):S79–S87CrossRef

26.

Ford HR, Jones P, Gaines B, Reblock K, Simpkins DL (2005) Intraoperative handling and wound healing: controlled clinical trial comparing coated VICRYL® plus antibacterial suture (coated Polyglactin 910 suture with triclosan) with coated VICRYL® suture (coated Polyglactin 910 suture). Surg Infect. Fall 6(3):313–321CrossRef

27.

Deliaert AE, Van den Kerckhove E, Tuinder S, Fieuws S, Sawor JH, Meesters-Caberg MA, van der Hulst RR (2009) The effect of triclosan-coated sutures in wound healing. A double blind randomised prospective pilot study. J Plast Reconstr Aesthet Surg 62(6):771–773CrossRefPubMed

Title: Effect of triclosan-coated sutures on surgical site infections in pilonidal disease: prospective randomized study
Authors: Naciye Cigdem Arslan
Gulsen Atasoy
Tansu Altintas
Cem Terzi
Publication date: 01-10-2018
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 10/2018
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-018-3138-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Effect of triclosan-coated sutures on surgical site infections in pilonidal disease: prospective randomized study

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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