Effect of Using Triclosan-Impregnated Polyglactin Suture to Prevent Infection of Saphenectomy Wounds in CABG: A Prospective, Double-Blind, Randomized Clinical Trial

Braz J Cardiovasc Surg. 2019 Dec 1;34(5):588-595. doi: 10.21470/1678-9741-2019-0048.

Abstract

Objective: To evaluate the efficacy of triclosan-coated suture for the reduction of infection in saphenectomy wounds of patients undergoing coronary artery bypass graft (CABG) surgery.

Methods: A total of 508 patients who underwent saphenectomy in CABG surgery were included in a prospective, randomized, double-blind trial from February/2011 to June/2014. Patients were randomized into the triclosan-coated suture group (n= 251) and the conventional non-antibiotic suture group (n=257). Demographic (gender and age), clinical (body mass index, diabetes, and use of analgesics), and intraoperative (cardiopulmonary bypass and cross-clamp times) variables and those related to the saphenectomy wound (pain, dehiscence, erythema, infection, necrosis, and hyperthermia) were measured and analyzed.

Results: Of the 508 patients who underwent saphenectomy, 69.9% were males and 40.2% were diabetic. Thirty-three (6.5%) patients presented infection: 13 (5.3%) with triclosan and 20 (7.9%) with conventional suture (P=0.281). Among diabetic patients (n=204), triclosan suture was used in 45.1% with four cases of infection; conventional suture was used in 54.9% of them, with 11 cases of infection. Most patients (94.3%) underwent on-pump CABG. Wound pain was observed in 9.9% of patients with triclosan-coated suture and in 17.9% with conventional suture (P=0.011). Wound hyperthermia was found in 1.6% of patients with triclosan-coated suture and in 5.4% of those with conventional suture (P=0.028).

Conclusion: Triclosan-coated suture shows lower infection rate in saphenectomy of patients undergoing CABG, although the differences were not statistically significant. Pain and wound hyperthermia were less frequent in patients with triclosan-coated sutures compared with conventional sutures.

Keywords: Analgesics; Body Mass Index; Cardiopulmonary Bypass; Coronary Artery Bypass Graft; Erythema; Pain; Sutures; Triclosan; Wound Infection.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Infective Agents, Local / therapeutic use*
  • Body Mass Index
  • Coronary Artery Bypass / adverse effects
  • Coronary Artery Bypass / methods*
  • Diabetes Complications
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain, Postoperative / prevention & control
  • Polyglactin 910 / therapeutic use*
  • Prospective Studies
  • Reproducibility of Results
  • Saphenous Vein / surgery*
  • Statistics, Nonparametric
  • Surgical Wound Infection / prevention & control*
  • Suture Techniques*
  • Time Factors
  • Treatment Outcome
  • Triclosan / therapeutic use*

Substances

  • Anti-Infective Agents, Local
  • Polyglactin 910
  • Triclosan

Grants and funding

Financial support: This study was funded by Ethicon Inc., represented in Brazil by Johnson & Johnson do Brasil Indústria e Comércio de Produtos para Saúde Ltda. Grant # 10-107.