Miyoshi Norikatsu, Fujino Shiki
Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Department of Innovative Oncology Research and Regenerative Medicine, Osaka International Cancer Institute, Osaka, Japan.
Surg Open Sci. 2023 Sep 14;16:73-76. doi: 10.1016/j.sopen.2023.09.009. eCollection 2023 Dec.
Previous randomized trials evaluated the effectiveness of triclosan-coated sutures for fascial closure in preventing surgical site infection (SSI). However, available evidence remains still inconclusive. We aimed to evaluate the effectiveness of triclosan-coated sutures in fascia closure in preventing postoperative SSI in elective gastrointestinal surgery.
META-ANALYSIS: A meta-analysis included present outcomes, evaluating the advantages of triclosan-coated compared with non-coated sutures in preventing SSIs for fascia closure of laparotomy in abdominal gastrointestinal surgery. To identify prospective randomized trials regarding this topic, we searched Cochrane Central Register of Controlled Trials (Central) and PubMed with the following search terms: "triclosan or triclosan coated;" "surgical site infection;" and "randomized controlled trial" was searched, respectively. To avoid the evaluation of the heterogenous group of patients, the following studies were excluded; only emergency surgery, or not including gastroenterological surgery. The Mantel-Haenszel random-effects model was performed with R software (CRAN, 3·6·2; https://cran.r-project.org/).
This meta-analysis included eleven phase-III and two prospective studies, which comprised 9588 patients. The aggregated phase-III results of the trials demonstrate a significant superiority of triclosan-coated sutures compared with non-coated sutures (random-effect model, OR 0.71, 95 % CI 0.56-0.90, = 0.0052).
The meta-analysis showed benefit with triclosan-coated sutures in preventing SSI after gastrointestinal surgery.
既往随机试验评估了三氯生涂层缝线用于筋膜闭合预防手术部位感染（SSI）的有效性。然而，现有证据仍不确凿。我们旨在评估三氯生涂层缝线在择期胃肠手术中用于筋膜闭合预防术后SSI的有效性。
一项荟萃分析纳入了当前结果，评估了三氯生涂层缝线与未涂层缝线相比在腹部胃肠手术剖腹术筋膜闭合预防SSI方面的优势。为识别关于该主题的前瞻性随机试验，我们分别使用以下检索词在Cochrane对照试验中心注册库（Central）和PubMed中进行检索：“三氯生或三氯生涂层”；“手术部位感染”；以及“随机对照试验”。为避免对异质性患者群体进行评估，排除了以下研究；仅为急诊手术，或未包括胃肠外科手术。使用R软件（CRAN，3·6·2；https://cran.r-project.org/）进行Mantel-Haenszel随机效应模型分析。
该荟萃分析纳入了11项III期研究和2项前瞻性研究，共9588例患者。试验的汇总III期结果表明，与未涂层缝线相比，三氯生涂层缝线具有显著优势（随机效应模型，OR 0.71，95%CI 0.56 - 0.90，P = 0.0052）。
荟萃分析表明三氯生涂层缝线在预防胃肠手术后SSI方面有益。
