The Effect of Antibiotic-Coated Sutures on the Incidence of Surgical Site Infections in Abdominal Closures: a Meta-Analysis

J Gastrointest Surg. 2017 May;21(5):896-903. doi: 10.1007/s11605-017-3357-6. Epub 2017 Jan 18.

Abstract

Objective: This meta-analysis aims to determine if antibiotic-impregnated sutures for abdominal fascial closure prevent postoperative surgical site infections (SSIs), hernias, and/or dehiscence.

Methods: MEDLINE and EMBASE databases (1946-2016) were searched. Randomized controlled trials comparing antibiotic-impregnated sutures to standard sutures for abdominal closure were eligible. Risk of bias was evaluated using the Cochrane Handbooks definitions.

Results: Four-hundred fifty articles were reviewed; five eligible studies (N = 3117) were identified. All studies routinely used prophylactic antibiotics. Overall risk of SSI in the antibiotic-impregnated suture group was 10.4 vs. 13.0% in the control group. Pooled data showed no difference in SSI between suture types (odds ratio 0.79, 95% CI 0.57-1.09, P = 0.15, I 2 = 44%). There was no evidence of subgroup effect by suture material (polydioxanone vs. polyglactin 910; P = 0.19) or by comparing colorectal surgery studies to others (P = 0.67). There was a high risk of bias in two studies, one for high loss to follow-up and one for not using an intent-to-treat analysis.

Conclusion: Our meta-analysis is the most comprehensive review on the utility of antibiotic-impregnated sutures in abdominal surgery to prevent SSI. We found no evidence to support routine use of these sutures.

Keywords: Abdominal closure; Antibiotic-coated sutures; Patient outcomes; SSI.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Abdominal Wall / surgery
  • Abdominal Wound Closure Techniques / adverse effects
  • Abdominal Wound Closure Techniques / instrumentation*
  • Administration, Topical
  • Anti-Bacterial Agents / administration & dosage*
  • Digestive System Surgical Procedures
  • Hernia, Abdominal / epidemiology
  • Hernia, Abdominal / etiology
  • Hernia, Abdominal / prevention & control
  • Humans
  • Incidence
  • Randomized Controlled Trials as Topic
  • Surgical Wound Dehiscence / epidemiology
  • Surgical Wound Dehiscence / etiology
  • Surgical Wound Dehiscence / prevention & control
  • Surgical Wound Infection / epidemiology*
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / prevention & control
  • Sutures*

Substances

  • Anti-Bacterial Agents