Abstract
Background
The use of absorbable sutures in wound closure has been shown to reduce the incidence of surgical site infection (SSI); however, there is no evidence that the intra-abdominal use of absorbable rather than silk sutures reduces the incidence of SSI after gastrointestinal surgery. We report the findings of a phase II trial, designed to evaluate the impact of the intra-abdominal use of absorbable sutures on the incidence of SSI.
Methods
At 19 Japanese hospitals, 1147 patients undergoing elective gastrectomy, colorectal surgery, hepatectomy, or pancreaticoduodenectomy (PD) were randomly assigned to absorbable or silk intra-abdominal suture groups. The primary efficacy endpoint was the incidence of SSI. The secondary efficacy endpoints were the locations of SSI, time to resolution of SSI, length of hospital stay, and the incidence of bile leakage in hepatectomy and pancreatic fistula.
Results
The incidence of SSI was 11.3%, 15.5%, 11.3%, and 36.9% after gastrectomy, colorectal surgery, hepatectomy, and PD, respectively. The incidence of SSI was higher in the absorbable suture group than in the silk suture group for all the surgical procedures, but the difference was not significant.
Conclusion
The intra-abdominal use of absorbable sutures did not have enough of an effect on the reduction of SSI in this phase II trial to justify the planning of a large-scale phase III trial.
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Change history
27 September 2017
In the original publication, the article category was published as “Review Article”. The correct category should read as “Original Article”.
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This work was supported by a grant from the Japan Surgical Society Clinical Investigation Project Award and a Health Labour Science Research Grant (Rinsho-Ippan-006).
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An erratum to this article is available at https://doi.org/10.1007/s00595-017-1589-4.
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Maehara, Y., Shirabe, K., Kohnoe, S. et al. Impact of intra-abdominal absorbable sutures on surgical site infection in gastrointestinal and hepato-biliary-pancreatic surgery: results of a multicenter, randomized, prospective, phase II clinical trial. Surg Today 47, 1060–1071 (2017). https://doi.org/10.1007/s00595-017-1480-3
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DOI: https://doi.org/10.1007/s00595-017-1480-3