Triclosan-Coated Sutures May Reduce the Risk of Surgical Site Infection After Spinal Surgery

First study to investigate the effects of the coated sutures on outcomes in spinal surgery

Peer Reviewed

Use of triclosan-coated sutures instead of non-coated sutures was associated with a significantly lower incidence of surgical site infections in patients undergoing spinal surgery, according to a retrospective, nonrandomized study published in The Spine Journal.
Operating room technician prepares suture for use with needle holderThis is the first study to investigate the effects of the coated sutures on outcomes in spinal surgery.The rate of spinal surgery infection is approximately 0.7% to 4.2%—higher than with knee or hip arthroplasty—and is linked to catastrophic events as well increased costs and delayed rehabilitation,  as noted by Ueno et al in the study background. Previous studies have demonstrated that use of triclosan-coated sutures is effective in prevention surgical site infections in the general operative, neurosurgical, and thoracic surgical fields; however, this is the first study to investigate the effects of the coated sutures on outcomes in spinal surgery.

The study assessed the number of wound infections among 405 patients who underwent spinal surgery at 2 university hospitals between May 2010 and April 2012. Conventional polyglactin 910 sutures were used for wound closure in 205 patients and triclosan-coated polyglactin 910 sutures (Vicryl® Plus, Ethicon US, LLC) were used in 200 patients.

Significantly Lower Rate of Infections Found

Wound infections occurred in 8 patients who received noncoated sutures (3.9%) compared with 1 patient who received triclosan-coated sutures (0.5%; P<0.05).

While the triclosan-coated sutures are more expensive than noncoated sutures, “the economic loss associated with the use of Vicryl Plus would be compensated even if one case of infection could be prevented,” the authors noted.

The findings are limited by the small number of surgical cases, low rates of infection, lack of randomization, and other potentially confounding factors, according to the editors of The Spine Journal. They called for an appropriately powered randomized controlled trial to determine whether the coated sutures decrease infection rates in spine surgery.

Updated on: 03/19/19
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Stewart G. Eidelson, MD

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