Can Triclosan-Coated Sutures and the Use of Double Gloves Reduce the Incidence of Surgical Site Infections?

Background: Postoperative surgical site infections (SSIs) are one of the most frequent complications after open abdominal surgery. Triclosan-coated sutures were said to be able to reduce its occurrence. In gynecologic surgery, SSIs of the vaginal stump are a frequent cause of postoperative fever. Double gloving is also said to contribute to the prevention of SSIs. We performed abdominal hysterectomy with double gloving and sutured the vagina stump with VICRYL PLUS ® , a Polyglactin 910 suture coated with triclosan, to prevent SSIs. We investigated whether triclosan-coated sutures coupled with double gloving could indeed reduce the incidence of SSIs following abdominal hysterectomy. Methods: We retrospectively reviewed 384 cases of abdominal hysterectomies operated in our department between April 2013 and March 2015. In the first period (from April 2013 to March 2014), we performed 195 operations with single gloving and sutured the vaginal stump with VICRYL ® (Polyglactin 910 suture without triclosan coat). In the second period (from April 2014 to March 2015), we performed 189 operations with double gloving and sutured the vaginal stump with VICRYL PLUS ® (Polyglactin 910 suture with triclosan coat). The primary outcome is the incidence of SSIs. Results: The two groups were comparable with respect to risk factors for SSIs. The incidences of SSIs in the first and second groups were 17 of 195 patients (8.7%) and eight of 189 patients (4.2%), respectively. The difference in the incidence of SSIs was not significant between the two groups (P = 0.097). The numbers of cases requiring postoperative antibiotic therapy in the first and second groups were 13 (6.7%) and 4 (2.1%). The incidence was higher in the control group (P = 0.045). None of the 189 cases needed drainage therapy or a re-operation. Conclusion: It is possible that triclosan-coated sutures coupled with double gloving are able to reduce SSIs and prevent SSI aggravation. J Clin Gynecol Obstet. 2017;6(1):1-5 doi: https://doi.org/10.14740/jcgo429w