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The Effect of Antibiotic-Coated Sutures on the Incidence of Surgical Site Infections in Abdominal Closures: a Meta-Analysis

  • Review Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Objective

This meta-analysis aims to determine if antibiotic-impregnated sutures for abdominal fascial closure prevent postoperative surgical site infections (SSIs), hernias, and/or dehiscence.

Methods

MEDLINE and EMBASE databases (1946–2016) were searched. Randomized controlled trials comparing antibiotic-impregnated sutures to standard sutures for abdominal closure were eligible. Risk of bias was evaluated using the Cochrane Handbooks definitions.

Results

Four-hundred fifty articles were reviewed; five eligible studies (N = 3117) were identified. All studies routinely used prophylactic antibiotics. Overall risk of SSI in the antibiotic-impregnated suture group was 10.4 vs. 13.0% in the control group. Pooled data showed no difference in SSI between suture types (odds ratio 0.79, 95% CI 0.57–1.09, P = 0.15, I 2 = 44%). There was no evidence of subgroup effect by suture material (polydioxanone vs. polyglactin 910; P = 0.19) or by comparing colorectal surgery studies to others (P = 0.67). There was a high risk of bias in two studies, one for high loss to follow-up and one for not using an intent-to-treat analysis.

Conclusion

Our meta-analysis is the most comprehensive review on the utility of antibiotic-impregnated sutures in abdominal surgery to prevent SSI. We found no evidence to support routine use of these sutures.

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Author Contribution

All authors contributed to designing the study, acquiring and analyzing data, and drafting/revising the manuscript.

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Authors and Affiliations

  1. Queen’s University School of Medicine, Kingston, ON, Canada

    Basheer Elsolh

  2. Department of Surgery, Kingston General Hospital, 76 Stuart Street, Burr 2, Kingston, ON, K7L 2V7, Canada

    Lisa Zhang & Sunil V. Patel

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  1. Basheer Elsolh
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  2. Lisa Zhang
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  3. Sunil V. Patel
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Correspondence to Sunil V. Patel.

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The authors declare that they have no conflict of interest.

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Elsolh, B., Zhang, L. & Patel, S.V. The Effect of Antibiotic-Coated Sutures on the Incidence of Surgical Site Infections in Abdominal Closures: a Meta-Analysis. J Gastrointest Surg 21, 896–903 (2017). https://doi.org/10.1007/s11605-017-3357-6

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  • DOI: https://doi.org/10.1007/s11605-017-3357-6

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