Antimicrobial coated sutures in Indian Market : A literature review of efficacy and safety in patients to prevent surgical site infections
Journal Title: Journal of the Indian Medical Association - Year 2019, Vol 117, Issue 6
Abstract
Surgical suture material is used to adequately adapt the wound edges. To prevent microbial colonization of the suture material in operative incisions, sutures with antibacterial activity have been developed. In India, triclosan coated sutures (Johnson & Johnson Ethicon Sutures) and chlorhexidine coated sutures (Sutures India, Meril life Sciences Pvt, Ltd, and Dolphin Sutures) are available. Both in vitro and in vivo experiments have shown that triclosan-coated sutures (TCS) are effective in the prevention of surgical site infections (SSIs). Our aim is to analyze the literature on efficacy and safety of antimicrobial sutures available in Indian market for prevention of SSIs following surgical procedures. We reviewed 23 randomized control trials (RCTs) and 5 meta-analyses. comparing antimicrobial-coated sutures with conventional sutures and assessing the clinical effectiveness of antimicrobial sutures to decrease the risk for surgical site infections (SSIs). In 7 RCTs and 4 meta-analyses, TCS coated sutures were statistically superior vs comparators for reducing SSIs; 4 RCTs documented that TCS coated sutures were better than comparator for reducing SSIs; in 6 studies TCS coated sutures were comparable to conventional sutures in reducing SSIs; 2 RCTs and 1 meta-analyses showed that TCS coated sutures were less effective (not statistically significant) than comparator. There was only 1 randomized clinical trial which documented that Chlorhexidine coated sutures is comparable to conventional sutures. The TCS antimicrobial suture was effective in decreasing the risk for postoperative SSIs in a broad population of patients undergoing surgery. Alternative substances are becoming clinically relevant, such as Chlorhexidine (CHX) coated sutures and only 1 in vivo and 6 in vitro scientific studies evaluated them. In vivo studies, large and comparative clinical research trials are recommended to validate the efficacy of CHX-coated sutures thus allowing their use in clinical practice.
Authors and Affiliations
Mukesh Gupta
Keywords
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