Triclosan-Impregnated Sutures to Decrease Surgical Site Infections Systematic Review and Meta-Analysis of Randomized Trials

Objective: To determine the efficacy and safety of triclosan-impregnated sutures. Background: Surgical-site infections (SSIs) produce considerable morbidity and increase health care costs. A potential strategy to decrease the rates of SSIs may be the use of triclosan-impregnated sutures. These have been endorsed and/or funded by professional and governmental bodies in numerous countries. Laboratory studies and nonsystematic reviews have suggested that these sutures may reduce SSIs but there has been no summative assessment of this intervention with regard to clinical efficacy and safety. Hence, a systematic review and meta-analysis of all randomized controlled trials (RCTs) investigating triclosan-impregnated sutures were conducted. Methods: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Pubmed databases, and trial registries were searched for published and unpublished RCTs. The endpoints of interest were the incidence of SSIs and wound breakdown. A random effects model was used and pooled estimates were reported as odds ratios (ORs) with the corresponding 95% confidence interval (CI). Results: Seven RCTs encompassing a total of 836 patients were included in the final analysis. The studies were of moderate quality. Triclosan-impregnated sutures did not statistically significantly reduce the rates of SSIs (OR = 0.77; 95% CI: 0.40-1.51; P = 0.45; I-2 = 24%). There was no difference in the rates of wound breakdown between the 2 groups (OR = 1.07; 95% CI: 0.21-5.43; P = 0.93; I-2 = 44%) Conclusions: Triclosan-impregnated sutures do not decrease the rate of SSIs or decrease the rate of wound breakdown. Further high-quality independent studies within the right context are required before routine clinical use can be considered.