Triclosan-containing sutures versus ordinary sutures for reducing surgical site infections in children: a double-blind, randomised controlled trial

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• 作者：Dr Marjo Renko ; MD^a ; ^b ; ^{marjo.renko@oulu.fi} ; Niko Paalanne ; MD^a ; ^b ; Terhi Tapiainen ; MD^a ; ^b ; Matti Hinkkainen ; BM^a ; Tytti Pokka ; MSc^b ; Sohvi Kinnula ; MD^a ; ^b ; Juha-Jaakko Sinikumpu ; MD^a ; ^b ; Prof Matti Uhari ; MD^a ; ^b ; Prof Willy Serlo ; MD^a ; ^b
• 刊名：The Lancet Infectious Diseases
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：17
• 期：1
• 页码：50-57
• 全文大小：277 K
• 卷排序：17

文摘

Surgical site infections (SSIs) are a pervasive problem in surgery. Sutures coated or impregnated with triclosan might reduce the occurrence of SSIs, but evidence of their efficacy is limited, especially in children.MethodsWe designed a randomised, double-blind, controlled trial in patients who underwent elective or daytime emergency surgery at Oulu University Hospital (Oulu, Finland). We included children younger than 18 years staying in the paediatric surgery and orthopaedics ward for any elective or emergency surgery during the daytime and with anticipated use of absorbing sutures. Children were randomly allocated (1:1) to receive either triclosan-containing sutures or ordinary absorbing sutures. The primary outcome was the occurrence of superficial or deep surgical site infections according to the Centers for Disease Control and Prevention criteria within 30 days after surgery. The primary analysis was with modified intention to treat. This trial is registered at ClinicalTrials.gov, number NCT01220700.FindingsBetween September, 2010, and December, 2014, 1633 children were recruited. In the modified intention-to-treat group, SSIs occurred in 20 (3%) of 778 patients allocated to receive triclosan-containing sutures and in 42 (5%) of 779 patients allocated to receive control sutures (risk ratio 0·48, 95% CI 0·28–0·80). To prevent one SSI, triclosan-containing sutures had to be used in 36 children (95% CI 21–111). One patient died from suspected mitochondrial disease; no other expected or unexpected adverse events were reported in either of the groups.InterpretationUse of triclosan-containing sutures effectively reduced the occurrence of all SSIs compared with normal sutures. The results accord with the results of meta-analyses of previous studies in adults. Use of triclosan-containing sutures is a simple way to reduce SSIs in children.FundingThe Alma and K A Snellman Foundation.