European Journal of Cardiovascular Medicine

Introduction: Surgical site infections (SSIs) continue to be one of the most common complications in conventional surgery. Various risk factors for the development of poor wound healing have been identified. An SSI is defined as an infection occurring within 30 days of surgery that meets the following criteria: (1) the diagnosis consists of the infection of an anatomic plane by one of the following manifestations: collection, inflammatory signs (pain, edema, tenderness, redness), dehiscence, or positive culture; and (2) classification according to the anatomic plane as follows: superficial incisional SSI, infection of the skin and subcutaneous tissue; deep incisional SSI, infection of the deep soft tissue (fascia and muscles); and organ/space SSI, infection of the organ/space. Objectives: A) To compare the incidence of superficial SSI in surgical incisions closed with coated polyglactin 910 suture with triclosan versus incisions closed with coated polyglactin 910 suture without triclosan. B) To study the time frame between surgery and development of SSI. C) To determine which bacteria is commonly associated with SSI after surgical closure. Material and Methods: This is a Randomized, prospective, open, single centre controlled study was conducted in the Department of General surgery, B.J Government Medical College and Sassoon general Hospital, Pune over a period of 1 year. Institutional Ethical Committee permission was obtained prior to commencement of the study. Intra-operative data was collected. It included the method of painting and draping, duration of the surgery, antibiotics received during surgery. intra-operative findings, wound class and subcutaneous tissue sutured with coated Polyglactin 910 suture with/without triclosan. Results: Mean age of case in Non-TCS group was 37.9 years, whereas mean age of TCS group was 36.8 years. P value of 'Student's t test for comparison of age distribution in Non-TCS and TCS groups was not significant. This assured the age matching of the two groups. 40 males and 33 females were included in Non-TCS group: 34 males and 30 females were included in TCS group. The Chi-square test was applied to observe the sex matching in two groups. P value was not significant, assuring the sex matching of two groups. Maximum number of case (40%) operated in Non-TCS group were Class II wounds, whereas maximum number of case (42%) operated in TCS group were Class I wounds. Least number of case, i.e., 9% in Non-TCS group and 8% in TCS group belonged to Class IV wounds. Conclusion: In our study, the incidence of Superficial SSI rate after surgery has been observed to be reduced with the use of triclosan coated suture (coated Polyglactin 910 suture with triclosan), but it was not totally eliminated. The pathogens cannot be completely eliminated from the site of surgery, but they can be minimized. Antimicrobial coated suture is a promising novel method to achieve the goal of least Surgical Site Infection (Superficial SSI) rates. Large scale trials are needed to further demonstrate the evidence of efficacy of antimicrobial (triclosan) coated suture material (coated Polyglactin 910 suture with triclosan) in reducing SSIS. More research is needed together with improved compliance with already established measures.701-706701-706