Majid Omer Waleed
Department of Oral and Maxillofacial Surgery, College of Dentistry, Mosul University, Mosul, Iraq.
Evid Based Dent. 2025 Mar;26(1):44-45. doi: 10.1038/s41432-024-01069-5. Epub 2024 Sep 23.
A literature search was conducted through PubMed and Scopus databases to identify articles published from January 2013 to May 2023, using appropriate search terms. There were no language restrictions. Additionally, reference lists of the included studies and key peer-reviewed journals in oral surgery were manually searched for further relevant studies.
Selection criteria targeted human clinical studies, including cohort studies, randomized clinical trials (RCTs), quasi-experimental studies, case reports, and case series that investigated the antimicrobial activity of antibacterial-coated sutures in oral surgery. Studies were excluded if they were in vitro, ex vivo, or animal studies, as well as if they were non-research or pre-print articles. Two authors independently selected studies, resolving disagreements through discussion or a third expert reviewer.
Two reviewers independently extracted data, including author, year, country, study design, sample size, population, intervention, control, surgery type, suture removal time, methodology, main results, and additional information. Discrepancies were resolved through discussion or with input from a third reviewer. This study followed the PRISMA-ScR guidelines for scoping reviews.
Out of 150 identified articles, 129 abstracts were reviewed after removing duplicates, and 10 full-text articles were screened, resulting in the inclusion of 5 studies published between 2014 and 2019. Three were RCTs, with one using a split-mouth design, involving 10 to 40 patients aged 18 to 60 years, primarily healthy. The sutures were mostly braided and coated with triclosan or chlorhexidine, while control groups used various non-coated sutures. Suture removal times ranged from 3 to 8 days. Postoperative rinses were advised in two studies, with one study not administering antibiotics and unclear antibiotic use in others. Three studies reported significantly reduced bacterial counts with antimicrobial-coated sutures compared to non-coated ones, while two studies found no significant differences. Triclosan-coated sutures generally showed greater antimicrobial activity, though results varied.
Antibacterial-coated sutures in oral surgery showed reduced bacterial retention compared to non-coated sutures. However, methodological variability, small sample sizes, and confounding factors limit the generalizability and reliability of these findings. High-quality RCTs with larger sample sizes are needed for more definitive conclusions. While antibacterial-coated sutures show promise in reducing microbial colonization and potentially improving surgical outcomes, their cost-effectiveness relative to non-coated sutures should be evaluated in larger clinical trials.
通过PubMed和Scopus数据库进行文献检索，使用适当的检索词来识别2013年1月至2023年5月发表的文章。没有语言限制。此外，还手动检索了纳入研究的参考文献列表以及口腔外科领域主要的同行评审期刊，以查找更多相关研究。
选择标准针对人类临床研究，包括队列研究、随机临床试验（RCT）、准实验研究、病例报告和病例系列，这些研究调查了口腔外科中抗菌涂层缝线的抗菌活性。如果研究是体外、离体或动物研究，以及非研究或预印本文章，则将其排除。两名作者独立选择研究，通过讨论或第三位专家评审解决分歧。
两名评审员独立提取数据，包括作者、年份、国家、研究设计、样本量、人群、干预措施、对照、手术类型、缝线拆除时间、方法、主要结果和其他信息。通过讨论或第三位评审员的意见解决差异。本研究遵循PRISMA-ScR范围综述指南。
在150篇识别出的文章中，去除重复项后对129篇摘要进行了评审，筛选了10篇全文文章，最终纳入了2014年至2019年发表的5项研究。三项为随机对照试验，其中一项采用了双侧对照设计，涉及10至40名年龄在18至60岁之间、基本健康的患者。缝线大多为编织型，涂有三氯生或氯己定，而对照组使用各种未涂层的缝线。缝线拆除时间为3至8天。两项研究建议术后进行冲洗，一项研究未使用抗生素，其他研究的抗生素使用情况不明。三项研究报告称，与未涂层缝线相比，抗菌涂层缝线的细菌计数显著降低，而两项研究未发现显著差异。三氯生涂层缝线通常显示出更大的抗菌活性，不过结果有所不同。
与未涂层缝线相比，口腔外科中的抗菌涂层缝线细菌残留减少。然而，方法学的变异性、样本量小和混杂因素限制了这些发现的普遍性和可靠性。需要开展样本量更大的高质量随机对照试验才能得出更明确的结论。虽然抗菌涂层缝线在减少微生物定植和潜在改善手术结果方面显示出前景，但相对于未涂层缝线的成本效益应在更大规模的临床试验中进行评估。
