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Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 10/2018

01-10-2018 | Review Article

The Efficacy of Antimicrobial-Coated Sutures for Preventing Incisional Surgical Site Infections in Digestive Surgery: a Systematic Review and Meta-analysis

Authors: Motoi Uchino, Toru Mizuguchi, Hiroki Ohge, Seiji Haji, Junzo Shimizu, Yasuhiko Mohri, Chizuru Yamashita, Yuichi Kitagawa, Katsunori Suzuki, Motomu Kobayashi, Masahiro Kobayashi, Fumie Sakamoto, Masahiro Yoshida, Toshihiko Mayumi, Koichi Hirata, On behalf of the SSI Prevention Guideline Committee of the Japan Society for Surgical Infection

Published in: Journal of Gastrointestinal Surgery | Issue 10/2018

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Abstract

Background

Antimicrobial-coated sutures have recently become well known for preventing surgical site infections (SSIs). However, the evidence and recommendations from some organizations remain controversial. Therefore, we conducted a systematic review and meta-analysis to analyze the efficacy of antimicrobial-coated sutures for preventing SSIs in digestive surgery.

Methods

We performed a systematic review of literature published from 2000 to 2017 (registered on PROSPERO, No. CRD42017076780). We included studies defined as randomized controlled trials (RCTs) and observational studies (OBSs) for the prevention of SSIs and the reduction in hospital stay length associated with digestive surgery.

Results

In the 10 RCTs, the incidence rates of incisional SSIs were 160/1798 (8.9%) with coated sutures and 205/1690 (12.1%) with non-coated sutures. Overall, antimicrobial-coated sutures were superior for reducing the incidence of incisional SSI (risk ratio (RR) 0.67, 95% confidence intervals (CI) 0.48–0.94, p = 0.02) in RCTs for digestive surgery with the mixed wound class and surgeries limited to a clean-contaminated wound (RR 0.66, 95% CI 0.44–0.98, p = 0.04). A superior effect of antimicrobial-coated sutures was found in 9 RCTs that involved only colorectal surgeries (RR 0.69, 95% CI 0.49–0.98, p = 0.04). The mean hospital stay length was similar with coated or uncoated sutures in 5 RCTs involving colorectal surgery (mean difference (MD) − 5.00, 95% CI 16.68–6.69, p = 0.4).

Conclusion

Antimicrobial-coated sutures are significantly more efficacious for preventing SSIs during digestive and colorectal surgery, even when restricted to clean-contaminated wounds. However, the hospital stay length was not affected.
Appendix
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Metadata
Title
The Efficacy of Antimicrobial-Coated Sutures for Preventing Incisional Surgical Site Infections in Digestive Surgery: a Systematic Review and Meta-analysis
Authors
Motoi Uchino
Toru Mizuguchi
Hiroki Ohge
Seiji Haji
Junzo Shimizu
Yasuhiko Mohri
Chizuru Yamashita
Yuichi Kitagawa
Katsunori Suzuki
Motomu Kobayashi
Masahiro Kobayashi
Fumie Sakamoto
Masahiro Yoshida
Toshihiko Mayumi
Koichi Hirata
On behalf of the SSI Prevention Guideline Committee of the Japan Society for Surgical Infection
Publication date
01-10-2018
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 10/2018
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-018-3832-8

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