Isik Isil, Selimen Deniz, Senay Sahin, Alhan Cem
Surgical Nursing Department, Health Sciences Faculty, Marmara University, Istanbul.
Heart Surg Forum. 2012 Feb;15(1):E40-5. doi: 10.1532/HSF98.20111106.
Postoperative surgical site infections (SSI) still greatly affect mortality and morbidity in cardiovascular surgery. SSI may be related to the suture material. In this prospective, randomized, controlled, and double-blinded study, the effect of antibacterial suture material on SSI in cardiac surgical patients was investigated.
We randomly allocated 510 patients into 2 groups. Antibacterial suture materials were used for wound closure in 170 patients (triclosan-coated suture group), and routine suture materials were used in 340 patients (noncoated suture group). All patients were evaluated for SSI on days 10, 20, and 30 following cardiac surgery.
Preoperative risk factors and laboratory findings were comparable for the 2 groups. Sternal infection occurred in 4 (2.4%) of the patients in the triclosan-coated suture group and in 3.5% of the noncoated suture group (P > .05). Leg wound infection occurred in 5 (3.5%) of the patients in the triclosan-coated suture group and in 3.8% of the noncoated suture group (P > .05). Only diabetes mellitus was an independent predictor of SSI.
Both noncoated and triclosan-coated suture materials are safe. Larger studies may be needed to show the benefit and cost-effectiveness, if any, of triclosan-coated materials over noncoated materials.
术后手术部位感染(SSI)仍对心血管手术的死亡率和发病率有很大影响。SSI可能与缝合材料有关。在这项前瞻性、随机、对照和双盲研究中,研究了抗菌缝合材料对心脏手术患者SSI的影响。
我们将510例患者随机分为2组。170例患者使用抗菌缝合材料进行伤口缝合(三氯生涂层缝合组),340例患者使用常规缝合材料(无涂层缝合组)。所有患者在心脏手术后第10、20和30天接受SSI评估。
两组患者的术前危险因素和实验室检查结果具有可比性。三氯生涂层缝合组4例(2.4%)患者发生胸骨感染,无涂层缝合组为3.5%(P>.05)。三氯生涂层缝合组5例(3.5%)患者发生腿部伤口感染,无涂层缝合组为3.8%(P>.05)。只有糖尿病是SSI的独立预测因素。
无涂层和三氯生涂层缝合材料都是安全的。可能需要更大规模的研究来证明三氯生涂层材料相对于无涂层材料的益处和成本效益(如果有的话)。