Triclosan-coated sutures reduce wound infections after hepatobiliary surgery-a prospective non-randomized clinical pathway driven study

Objectives Wound infections after abdominal surgery are still frequent types of nosocomial infections. Suture materials might serve as a vehicle for mechanical transport of bacteria into the surgical wound. To reduce bacterial adherence to surgical sutures, triclosan-coated polyglactin 910 suture materials with antiseptic activity (Vicryl plusA (R)) were developed. The aim of this prospective non-randomized clinical pathway driven study was to ascertain if the use of Vicryl plusA (R) reduced the number of wound infections after transverse laparotomy. Patients and methods Between October 2003 and October 2007, 839 operations were performed using a transverse abdominal incision. In the first time period, a PDSIIA (R) loop suture was used for abdominal wall closure. In the second time period, we used Vicryl plusA (R). Risk factors were collected prospectively to compare the two groups. Results Using a PDSIIA (R) loop suture for abdominal wall closure in the first time period, 9.2% of the patients developed wound infections. In the second time period, using Vicryl plusA (R), the number of wound infections decreased to 4.3% (p < 0,005). Both groups were comparable regarding risk factors despite no other changes in protocols of patient care. Conclusion Antiseptic-coated loop Vicryl suture for abdominal wall closure can be superior to PDSII sutures in respect to the development of wound infections after a two-layered closure of transverse laparotomy.