Antimicrobial-coated sutures to decrease incisional surgical site infections in gastrointestinal surgery

a systematic review and meta-analysis

Abstract

Background: Antimicrobial-coated suture has recently become well known for preventing surgical site infection (SSI). However, the evidence and recommendations from some organizations remains controversial. Therefore, we conducted a systematic review and meta-analysis to analyse the efficacy of antimicrobial-coated sutures for preventing SSIs in gastrointestinal surgery. Methods: We performed a systematic literature review. We included studies defined as randomized controlled trials（RCTs）and observational studies (OBSs) for the prevention of SSIs and a reduction in the length of hospital stays during gastrointestinal surgery. Results: A total of 15 studies including 10 RCTs and 5 OBSs were selected. In the results of the RCTs, antimicrobial-coated sutures were superior at reducing the incidence of incisional SSI (RR 0.68, 95% CI: 0.48–0.95, P=0.03). The superior effect of antimicrobial-coated sutures was also found in OBSs (OR 0.4, 95% CI: 0.3-0.54, P＜0.001). Although the superior effect of antimicrobial-coated suture was found in poly-filament suture material (RR 0.45, 95%CI: 0.26-0.77, P＝0.004), that was not found in poly-filament suture material (RR 0.82, 95%CI: 0.57-1.18, P=0.28). The mean length of hospital stays was similar. Conclusion: Antimicrobial-coated sutures are significantly more efficacious at preventing SSIs during either gastrointestinal or colorectal surgery. However, that efficacy was not found in the mono-filament suture material.