Department of General Surgery, Plastic Surgery "P. Valdoni", Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2019 Feb;23(3):958-964. doi: 10.26355/eurrev_201902_16982.
Surgical site infection (SSI) produces considerable morbidity and increases health care costs. One of its causes is microbial adherence to the surgical sutures surface. A strategy to avoid microbial colonization is the use of antimicrobial-impregnated sutures. Recently absorbable sutures treated with chlorhexidine (CHX) have been developed. Our study purpose was to compare CHX-coated and uncoated suture in elective plastic surgery.
We conducted a randomized, double-blind, single-centre controlled trial of 18 patients undergoing elective bilateral mammary surgery and 18 patients undergoing skin lesions removals. Patients were divided into 2 groups receiving antibacterial-coated (study group) and uncoated (controlled group) sutures for wound closure. Patients were evaluated for scar results and signs of SSIs were monitored over a period of 30 days (or 1 year in case of prosthetic surgery). Statistical comparison was performed using dependent t-tests for paired samples.
For patients undergoing mammary surgery, based on Vancouver Scale, there were no significant differences between the two groups. We noticed that in 8 patients the vertical scars belonging to the control group were larger than the contralateral 8 vertical sutures belonging to the study group. For patients undergoing skin surgery, surgical wounds treated with uncoated sutures were significantly more erythematous than the ones belonging to the study group (Media: 0,8333% vs. 1,5556%, respectively; standard deviation: 9,235 vs. 0,6157; 95%; p=0.0092).
No wounds infection was reported between the two groups. Based on our experience, we conclude that the use of CHX-coated sutures should be considered in case of inflamed lesions removal. Further studies are needed to validate our results.
手术部位感染（SSI）会导致相当大的发病率，并增加医疗保健成本。其原因之一是微生物附着在手术缝线表面。避免微生物定植的策略是使用抗菌缝线。最近开发了用洗必泰（CHX）处理的可吸收缝线。我们的研究目的是比较择期整形手术中 CHX 涂层缝线和未涂层缝线。
我们进行了一项随机、双盲、单中心对照试验，纳入 18 例行双侧乳房手术的患者和 18 例行皮肤病变切除术的患者。患者分为接受抗菌涂层（研究组）和未涂层（对照组）缝线缝合伤口的两组。对患者进行疤痕结果评估，并在 30 天（或假体手术 1 年）期间监测 SSI 迹象。使用配对样本的依赖 t 检验进行统计比较。
对于接受乳房手术的患者，根据温哥华量表，两组之间没有显著差异。我们注意到，在 8 例患者中，对照组的垂直疤痕比研究组的对侧 8 条垂直缝线大。对于接受皮肤手术的患者，未涂层缝线处理的手术伤口明显比研究组的手术伤口更红肿（中位数：0.8333%比 1.5556%；标准差：9.235 比 0.6157；95%；p=0.0092）。
两组均未报告伤口感染。根据我们的经验，我们得出结论，在炎症性病变切除时应考虑使用 CHX 涂层缝线。需要进一步的研究来验证我们的结果。
