Hoshino Seiichiro, Yoshida Yoichiro, Tanimura Syu, Yamauchi Yasushi, Noritomi Tomoaki, Yamashita Yuichi
Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.
Int Surg. 2013 Apr-Jun;98(2):129-32. doi: 10.9738/CC179.
To reduce bacterial adherence to surgical sutures, triclosan-coated polyglactin 910 suture materials with antiseptic activity were developed. The aim of this study was to evaluate whether the incidence of surgical site infections can be reduced when triclosan-coated sutures are used. Until December 2009, we used conventional polyglactin 910 sutures (VICRYL, Ethicon) for the closure of the fascia in digestive tract surgery. Therefore, for the control group we retrospectively collected surveillance data for 1.5 years. In the control group, 611 patients underwent digestive tract surgery with VICRYL sutures. Beginning in July 2010, we used triclosan-coated polyglactin 910 sutures (VICRYL Plus, Ethicon, Tokyo, Japan) for the closure of the fascia in all digestive surgeries. So, we collected data for the study group from July 2010 until June 2011. In the study group, 467 patients underwent digestive tract surgery with triclosan-coated VICRYL Plus sutures. In the control group, 75 patients (12.2%) developed wound infections. In the study group, 31 patients (6.6%) developed wound infections, which was significantly lower. Emergency cases; laparoscopic cases, including some cholecystectomy and colectomy cases; American Society of Anesthesiologists classification; the use of immunosuppressive therapy; colostomy cases; wound classification; and suture material were identified as the risk factors for wound infections. In both groups, as the wound classification worsened, the wound infection rate increased. Triclosan-coated polyglactin 910 antimicrobial sutures lead to a significant decrease in the incidence of surgical site infections, especially in clean/contaminated cases.
为减少细菌对外科缝线的黏附，人们研发了具有抗菌活性的三氯生涂层聚乙醇酸910缝线材料。本研究的目的是评估使用三氯生涂层缝线是否能降低手术部位感染的发生率。直到2009年12月，我们在消化道手术中使用传统的聚乙醇酸910缝线（爱惜康公司的薇乔缝线）来缝合筋膜。因此，我们回顾性收集了对照组1.5年的监测数据。在对照组中，611例患者使用薇乔缝线进行了消化道手术。从2010年7月开始，我们在所有消化道手术中使用三氯生涂层聚乙醇酸910缝线（日本东京爱惜康公司的薇乔加强型缝线）来缝合筋膜。所以，我们收集了2010年7月至2011年6月研究组的数据。在研究组中，467例患者使用三氯生涂层薇乔加强型缝线进行了消化道手术。在对照组中，75例患者（12.2%）发生了伤口感染。在研究组中，31例患者（6.6%）发生了伤口感染，这一比例显著更低。急诊病例；腹腔镜手术病例，包括一些胆囊切除术和结肠切除术病例；美国麻醉医师协会分级；免疫抑制治疗的使用；结肠造口术病例；伤口分级；以及缝线材料被确定为伤口感染的危险因素。在两组中，随着伤口分级的恶化，伤口感染率均升高。三氯生涂层聚乙醇酸910抗菌缝线可显著降低手术部位感染的发生率，尤其是在清洁/污染手术病例中。
