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首页> 外文期刊>Surgical infections >Surgical Site Infections after Abdominal Closure in Colorectal Surgery Using Triclosan-Coated Absorbable Suture (PDS Plus) vs. Uncoated Sutures (PDS II): A Randomized Multicenter Study
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Surgical Site Infections after Abdominal Closure in Colorectal Surgery Using Triclosan-Coated Absorbable Suture (PDS Plus) vs. Uncoated Sutures (PDS II): A Randomized Multicenter Study

机译：使用三氯生包被的可吸收缝合线（PDS Plus）与未包被的缝合线（PDS II）对结直肠手术进行腹部闭合手术后的手术部位感染：一项随机的多中心研究

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Background: Surgical site infections (SSI) are the third most common hospital-acquired infections and account for 14% to 16% of all such infections. In elective colorectal operations, the international SSI rate ranges from 4.7%-25%. In a previous retrospective study in this department, the SSI rate was unacceptably high (25%), and the promising different international evaluations of triclosan-coated suture materials encouraged us to create a multicenter randomized trial to improve our results. The main goal of this study was to compare triclosan-coated and uncoated absorbable suture (PDS Plus~® with PDS II~®) in elective colorectal operations. Methods: This was an internet-based study involving seven surgical centers. All the elective colorectal operations were performed by experienced surgeons. For abdominal fascia closure, running looped PDS was applied; triclosan-coated or uncoated PDS was chosen by computer randomization. Pre-operative and peri-operative variables such as gender, body mass index, neoadjuvant therapy, type II diabetes mellitus, amount of wound dressing material used, nursing days, and microbiological results were recorded. After the operation, the patient's data and risk factors were collected in a password-protected online database. Results: From 485 patients randomized, SSI was documented in 47 patients (12.5%), 23 (12.2%) in the group having triclosan-coated sutures (n=188) and 24 (12.2%) in the uncoated suture group (n=197), a non-significant difference. Of all SSIs, 13 (27.7%) were diagnosed only after discharge, being recognized in the outpatient setting, with four patients in the triclosan suture group (8.5%) and nine in the uncoated suture group (19.2%) being affected with no significant differences in the demographic data. Microbiological examinations, in addition to the same colon flora in both groups, revealed two gram-positive infections in the uncoated suture group. The hospital stay and costs of dressings were significantly higher in patients having SSIs. Conclusion: Compared with the previous retrospective studies of this department, the implementation of looped PDS decreased the incidence of SSI by one-half, whether the suture was triclosan-coated or not. It seems that patient factors are less important than operative factors in the occurrence of SSI, and there were no differences between elective colon and rectal operations in the development of incisional infections. No beneficial effect of triclosan against gram-positive bacteria, which has been reported in the literature, could be confirmed in our study. We could not show an effect against gram-negative enteric microorganisms. Higher additional costs and longer hospital stay with SSI were confirmed.
机译：背景：手术部位感染（SSI）是第三大最常见的医院获得性感染，占所有此类感染的14％至16％。在选择性结直肠手术中，国际SSI率介于4.7％-25％之间。在该部门以前的回顾性研究中，SSI率高得令人无法接受（25％），并且对三氯生包被的缝合材料的有希望的不同国际评价鼓励我们开展一项多中心随机试验以改善我们的结果。这项研究的主要目的是比较三氯生包衣和未包衣的可吸收缝合线（PDS Plus〜®与PDS II〜®）在选择性结直肠手术中的作用。方法：这是一项基于互联网的研究，涉及七个手术中心。所有的选择性结直肠手术均由经验丰富的外科医生进行。对于腹部筋膜闭合，应用连续环状PDS；通过计算机随机选择三氯生包被的或未包被的PDS。记录术前和围术期变量，例如性别，体重指数，新辅助治疗，II型糖尿病，伤口敷料的使用量，护理天数和微生物学结果。手术后，将患者的数据和危险因素收集在受密码保护的在线数据库中。结果：从485名随机分组的患者中，SSI被记录为47例（12.5％），三氯生涂层缝合线组（n = 188）中的23例（12.2％）和未涂层缝合线组中24例（12.2％）（n = 197），差异不大。在所有SSI中，只有在出院后才被诊断出的SSI，在门诊就可以识别，三氯生缝合组中有4例患者（8.5％），无涂层缝合组中有9例（19.2％）受到影响，无显着性人口统计数据的差异。两组微生物检查相同，除了结肠菌群相同外，未涂膜缝合组还发现了两次革兰氏阳性感染。患有SSI的患者的住院时间和敷料费用明显更高。结论：与该部门以前的回顾性研究相比，无论缝合线是否为三氯生涂层，实施环形PDS可使SSI的发生率降低一半。在SSI的发生中，患者因素似乎不如手术因素重要，在切口感染的发生过程中，选择性结肠手术和直肠手术之间没有差异。在我们的研究中没有证实三氯生对革兰氏阳性细菌的有益作用。我们无法显示出对革兰氏阴性肠微生物的作用。 SSI证实了更高的额外费用和更长的住院时间。

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  • 来源
    《Surgical infections》 |2011年第6期|p.483-489|共7页
  • 作者

    Jozsef Baracs; Orsolya Huszar; Shahram Ghotb Sajjadi; OE. Peter Horvath;

  • 作者单位

    Department of Surgery University of Pecs 13 Ifjusdg str. Pecs H-7624, Hungary;

    rnDepartment of Surgery, University of Pecs, Pecs, Hungary;

    rnDepartment of Surgery, University of Pecs, Pecs, Hungary;

    rnDepartment of Surgery, University of Pecs, Pecs, Hungary;

  • 收录信息 美国《化学文摘》(CA);
  • 原文格式 PDF
  • 正文语种 eng
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