The Efficacy of Antimicrobial-Coated Sutures for Preventing Incisional Surgical Site Infections in Digestive Surgery: a Systematic Review and Meta-analysis

On behalf of the SSI Prevention Guideline Committee of the Japan Society for Surgical Infection

Research output: Contribution to journalArticle

Abstract

Background: Antimicrobial-coated sutures have recently become well known for preventing surgical site infections (SSIs). However, the evidence and recommendations from some organizations remain controversial. Therefore, we conducted a systematic review and meta-analysis to analyze the efficacy of antimicrobial-coated sutures for preventing SSIs in digestive surgery. Methods: We performed a systematic review of literature published from 2000 to 2017 (registered on PROSPERO, No. CRD42017076780). We included studies defined as randomized controlled trials (RCTs) and observational studies (OBSs) for the prevention of SSIs and the reduction in hospital stay length associated with digestive surgery. Results: In the 10 RCTs, the incidence rates of incisional SSIs were 160/1798 (8.9%) with coated sutures and 205/1690 (12.1%) with non-coated sutures. Overall, antimicrobial-coated sutures were superior for reducing the incidence of incisional SSI (risk ratio (RR) 0.67, 95% confidence intervals (CI) 0.48–0.94, p = 0.02) in RCTs for digestive surgery with the mixed wound class and surgeries limited to a clean-contaminated wound (RR 0.66, 95% CI 0.44–0.98, p = 0.04). A superior effect of antimicrobial-coated sutures was found in 9 RCTs that involved only colorectal surgeries (RR 0.69, 95% CI 0.49–0.98, p = 0.04). The mean hospital stay length was similar with coated or uncoated sutures in 5 RCTs involving colorectal surgery (mean difference (MD) − 5.00, 95% CI 16.68–6.69, p = 0.4). Conclusion: Antimicrobial-coated sutures are significantly more efficacious for preventing SSIs during digestive and colorectal surgery, even when restricted to clean-contaminated wounds. However, the hospital stay length was not affected.

Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalJournal of Gastrointestinal Surgery
DOIs
Publication statusAccepted/In press - Jun 20 2018

Fingerprint

Surgical Wound Infection
Sutures
Meta-Analysis
Randomized Controlled Trials
Colorectal Surgery
Confidence Intervals
Length of Stay
Odds Ratio
Wounds and Injuries
Incidence
Observational Studies

Keywords

  • Antimicrobial-coated suture
  • Colorectal surgery
  • Digestive surgery
  • Surgical site infection

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

The Efficacy of Antimicrobial-Coated Sutures for Preventing Incisional Surgical Site Infections in Digestive Surgery : a Systematic Review and Meta-analysis. / On behalf of the SSI Prevention Guideline Committee of the Japan Society for Surgical Infection.

In: Journal of Gastrointestinal Surgery, 20.06.2018, p. 1-10.

Research output: Contribution to journalArticle

@article{5dd36d78d5de42c0b8a66bdf7504224d,
title = "The Efficacy of Antimicrobial-Coated Sutures for Preventing Incisional Surgical Site Infections in Digestive Surgery: a Systematic Review and Meta-analysis",
abstract = "Background: Antimicrobial-coated sutures have recently become well known for preventing surgical site infections (SSIs). However, the evidence and recommendations from some organizations remain controversial. Therefore, we conducted a systematic review and meta-analysis to analyze the efficacy of antimicrobial-coated sutures for preventing SSIs in digestive surgery. Methods: We performed a systematic review of literature published from 2000 to 2017 (registered on PROSPERO, No. CRD42017076780). We included studies defined as randomized controlled trials (RCTs) and observational studies (OBSs) for the prevention of SSIs and the reduction in hospital stay length associated with digestive surgery. Results: In the 10 RCTs, the incidence rates of incisional SSIs were 160/1798 (8.9{\%}) with coated sutures and 205/1690 (12.1{\%}) with non-coated sutures. Overall, antimicrobial-coated sutures were superior for reducing the incidence of incisional SSI (risk ratio (RR) 0.67, 95{\%} confidence intervals (CI) 0.48–0.94, p = 0.02) in RCTs for digestive surgery with the mixed wound class and surgeries limited to a clean-contaminated wound (RR 0.66, 95{\%} CI 0.44–0.98, p = 0.04). A superior effect of antimicrobial-coated sutures was found in 9 RCTs that involved only colorectal surgeries (RR 0.69, 95{\%} CI 0.49–0.98, p = 0.04). The mean hospital stay length was similar with coated or uncoated sutures in 5 RCTs involving colorectal surgery (mean difference (MD) − 5.00, 95{\%} CI 16.68–6.69, p = 0.4). Conclusion: Antimicrobial-coated sutures are significantly more efficacious for preventing SSIs during digestive and colorectal surgery, even when restricted to clean-contaminated wounds. However, the hospital stay length was not affected.",
keywords = "Antimicrobial-coated suture, Colorectal surgery, Digestive surgery, Surgical site infection",
author = "{On behalf of the SSI Prevention Guideline Committee of the Japan Society for Surgical Infection} and Motoi Uchino and Toru Mizuguchi and Hiroki Ohge and Seiji Haji and Junzo Shimizu and Yasuhiko Mohri and Chizuru Yamashita and Yuichi Kitagawa and Katsunori Suzuki and Motomu Kobayashi and Masahiro Kobayashi and Fumie Sakamoto and Masahiro Yoshida and Toshihiko Mayumi and Koichi Hirata",
year = "2018",
month = "6",
day = "20",
doi = "10.1007/s11605-018-3832-8",
language = "English",
pages = "1--10",
journal = "Journal of Gastrointestinal Surgery",
issn = "1091-255X",
publisher = "Springer New York",

}

TY - JOUR

T1 - The Efficacy of Antimicrobial-Coated Sutures for Preventing Incisional Surgical Site Infections in Digestive Surgery

T2 - a Systematic Review and Meta-analysis

AU - On behalf of the SSI Prevention Guideline Committee of the Japan Society for Surgical Infection

AU - Uchino, Motoi

AU - Mizuguchi, Toru

AU - Ohge, Hiroki

AU - Haji, Seiji

AU - Shimizu, Junzo

AU - Mohri, Yasuhiko

AU - Yamashita, Chizuru

AU - Kitagawa, Yuichi

AU - Suzuki, Katsunori

AU - Kobayashi, Motomu

AU - Kobayashi, Masahiro

AU - Sakamoto, Fumie

AU - Yoshida, Masahiro

AU - Mayumi, Toshihiko

AU - Hirata, Koichi

PY - 2018/6/20

Y1 - 2018/6/20

N2 - Background: Antimicrobial-coated sutures have recently become well known for preventing surgical site infections (SSIs). However, the evidence and recommendations from some organizations remain controversial. Therefore, we conducted a systematic review and meta-analysis to analyze the efficacy of antimicrobial-coated sutures for preventing SSIs in digestive surgery. Methods: We performed a systematic review of literature published from 2000 to 2017 (registered on PROSPERO, No. CRD42017076780). We included studies defined as randomized controlled trials (RCTs) and observational studies (OBSs) for the prevention of SSIs and the reduction in hospital stay length associated with digestive surgery. Results: In the 10 RCTs, the incidence rates of incisional SSIs were 160/1798 (8.9%) with coated sutures and 205/1690 (12.1%) with non-coated sutures. Overall, antimicrobial-coated sutures were superior for reducing the incidence of incisional SSI (risk ratio (RR) 0.67, 95% confidence intervals (CI) 0.48–0.94, p = 0.02) in RCTs for digestive surgery with the mixed wound class and surgeries limited to a clean-contaminated wound (RR 0.66, 95% CI 0.44–0.98, p = 0.04). A superior effect of antimicrobial-coated sutures was found in 9 RCTs that involved only colorectal surgeries (RR 0.69, 95% CI 0.49–0.98, p = 0.04). The mean hospital stay length was similar with coated or uncoated sutures in 5 RCTs involving colorectal surgery (mean difference (MD) − 5.00, 95% CI 16.68–6.69, p = 0.4). Conclusion: Antimicrobial-coated sutures are significantly more efficacious for preventing SSIs during digestive and colorectal surgery, even when restricted to clean-contaminated wounds. However, the hospital stay length was not affected.

AB - Background: Antimicrobial-coated sutures have recently become well known for preventing surgical site infections (SSIs). However, the evidence and recommendations from some organizations remain controversial. Therefore, we conducted a systematic review and meta-analysis to analyze the efficacy of antimicrobial-coated sutures for preventing SSIs in digestive surgery. Methods: We performed a systematic review of literature published from 2000 to 2017 (registered on PROSPERO, No. CRD42017076780). We included studies defined as randomized controlled trials (RCTs) and observational studies (OBSs) for the prevention of SSIs and the reduction in hospital stay length associated with digestive surgery. Results: In the 10 RCTs, the incidence rates of incisional SSIs were 160/1798 (8.9%) with coated sutures and 205/1690 (12.1%) with non-coated sutures. Overall, antimicrobial-coated sutures were superior for reducing the incidence of incisional SSI (risk ratio (RR) 0.67, 95% confidence intervals (CI) 0.48–0.94, p = 0.02) in RCTs for digestive surgery with the mixed wound class and surgeries limited to a clean-contaminated wound (RR 0.66, 95% CI 0.44–0.98, p = 0.04). A superior effect of antimicrobial-coated sutures was found in 9 RCTs that involved only colorectal surgeries (RR 0.69, 95% CI 0.49–0.98, p = 0.04). The mean hospital stay length was similar with coated or uncoated sutures in 5 RCTs involving colorectal surgery (mean difference (MD) − 5.00, 95% CI 16.68–6.69, p = 0.4). Conclusion: Antimicrobial-coated sutures are significantly more efficacious for preventing SSIs during digestive and colorectal surgery, even when restricted to clean-contaminated wounds. However, the hospital stay length was not affected.

KW - Antimicrobial-coated suture

KW - Colorectal surgery

KW - Digestive surgery

KW - Surgical site infection

UR - http://www.scopus.com/inward/record.url?scp=85048812168&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85048812168&partnerID=8YFLogxK

U2 - 10.1007/s11605-018-3832-8

DO - 10.1007/s11605-018-3832-8

M3 - Article

C2 - 29926317

AN - SCOPUS:85048812168

SP - 1

EP - 10

JO - Journal of Gastrointestinal Surgery

JF - Journal of Gastrointestinal Surgery

SN - 1091-255X

ER -