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使用含三氯生缝线进行切口闭合对犬胫骨平台水平截骨术后手术部位感染及炎症的影响。

Effect of using triclosan-impregnated suture for incisional closure on surgical site infection and inflammation following tibial plateau leveling osteotomy in dogs.

作者信息

Etter Sean W, Ragetly Guillaume R, Bennett R Avery, Schaeffer David J

机构信息

Department of Veterinary Clinical Medicine, University of Illinois, Urbana, IL 61802, USA.

出版信息

J Am Vet Med Assoc. 2013 Feb 1;242(3):355-8. doi: 10.2460/javma.242.3.355.

Abstract

OBJECTIVE

To compare surgical site infection and inflammation rates between the use of nonimpregnated (polydioxanone and poliglecaprone 25) versus triclosan-impregnated (polydioxanone and poliglecaprone 25) suture for incisional closure in dogs undergoing a standardized orthopedic procedure (tibial plateau leveling osteotomy [TPLO]).

DESIGN

Retrospective cohort study.

ANIMALS

283 dogs that underwent TPLO between November 2005 and December 2009.

PROCEDURES

Medical records were reviewed for age; body weight; body condition score; use of propofol; perioperative and postoperative administration of antimicrobials; presence of a preoperative infection; use of a jig; technique of joint exploration; type of suture material (triclosan impregnated vs nonimpregnated) used to close the pes anserinus, subcutaneous layer, and subcuticular layer; use of staples or suture to close the skin; and surgery and anesthesia durations. The outcome variables were surgical site inflammation and infection.

RESULTS

Rates of infection and inflammation did not differ between surgeries for which triclosan-impregnated suture was used (n = 159 [8.8%, and 18.8%, respectively]) and those for which nonimpregnated suture was used (112 [10.7% and 15.2%, respectively]). The use of staples, compared with suture, to close the skin significantly decreased the inflammation rate.

CONCLUSIONS AND CLINICAL RELEVANCE

Compared with in vitro conditions, in vivo conditions (where the environment is not controlled and triclosan may elute more quickly from the suture) may decrease the antibacterial effectiveness of triclosan-impregnated suture. On the basis of our findings, triclosan-impregnated sutures did not seem to provide an additional benefit for clinical use and cannot be strongly recommended for elective orthopedic procedures in veterinary medicine.

摘要

目的

比较在接受标准化骨科手术(胫骨平台水平截骨术[TPLO])的犬只中,使用未浸渍(聚二氧六环酮和聚乙醇酸 25)与三氯生浸渍(聚二氧六环酮和聚乙醇酸 25)缝线进行切口闭合后的手术部位感染和炎症发生率。

设计

回顾性队列研究。

动物

2005 年 11 月至 2009 年 12 月期间接受 TPLO 的 283 只犬。

步骤

查阅病历以获取年龄、体重、身体状况评分、丙泊酚的使用情况、围手术期和术后抗菌药物的使用情况、术前感染的存在情况、夹具的使用情况、关节探查技术、用于闭合鹅足、皮下层和皮下组织层的缝线材料类型(三氯生浸渍与未浸渍)、使用钉书钉或缝线闭合皮肤的情况以及手术和麻醉持续时间。结果变量为手术部位炎症和感染。

结果

使用三氯生浸渍缝线的手术(n = 159,感染率和炎症率分别为 8.8%和 18.8%)与使用未浸渍缝线的手术(112 例,感染率和炎症率分别为 10.7%和 15.2%)之间的感染率和炎症率无差异。与缝线相比,使用钉书钉闭合皮肤显著降低了炎症发生率。

结论及临床意义

与体外条件相比,体内条件(环境不受控制且三氯生可能更快地从缝线中洗脱)可能会降低三氯生浸渍缝线的抗菌效果。根据我们的研究结果,三氯生浸渍缝线似乎并未为临床应用带来额外益处,因此在兽医学中,对于择期骨科手术不能强烈推荐使用。

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