Triclosan-coated sutures for the reduction of sternal wound infections? A retrospective observational analysis

Objectives: Sternal wound infections are an infrequent but serious complication of cardiac surgery, leading to a prolonged hospital stay, increased costs and greater morbidity. To prevent bacterial colonisation of the suture material, which disables local mechanisms of wound decontamination, sutures coated with triclosan were developed. The current study set out to evaluate the effectiveness of such sutures against the development of sternal wound infections after cardiac surgery. Methods: Between October 2006 and October 2007, a total of 963 patients underwent cardiac surgery with a standard median sternotomy and cardiopulmonary bypass at the General Hospital of Vienna (AKH). A total of 198 patients had their wounds closed with normal sutures, and 765 with the new triclosan-coated sutures. Of these 765 patients, 678 received total closure (sternal fascia, subcutaneous tissue and skin) using the new sutures, whereas in 87 patients the new sutures were used only for the sternal fascia. The study was designed as not being double-blinded, and evaluation was carried out retrospectively. Results: The rate of sternal wound infection was 3.0% in the conventionally closed group, 2.3% in the group with only the sternal fascia closed using triclosan sutures, and 3.2% in the group with total triclosan suture closure (fascia, subcutaneous tissue and skin). Conclusions: Triclosan-coated sutures therefore showed no advantage in avoiding or reducing sternal wound infections. As the cost of these new materials is higher, the rationale for using these sutures remains to be determined. (c) 2011 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.