Do antibacterial-coated sutures reduce wound infection in head and neck cancer reconstruction?

Shih-Yi Chen, Tim-Mo Chen, Niann-Tzyy Dai, Ju-Peng Fu, Shun-Cheng Chang, Shou-Cheng Deng, Shyi-Gen Chen

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: Surgical wound infection is a common complication, which increases the hospital stay and costs after surgery for head and neck cancer. In this study, we evaluated the effect of Triclosan-coated sutures on surgical wounds and analyzed the risk factors for wound infections in head and neck cancer surgery. Patients and Methods: From January 2007 to December 2009, 253 consecutive patients underwent wide excision of a head or neck cancer and reconstructive procedures. All patient data were collected prospectively. Of these, 241 patients were included in this study, divided into two groups. The Triclosan group contained 112 patients, whose surgical wounds were closed with Triclosan-coated sutures (Vicryl Plus). The control group included the remaining 129 patients, whose surgical wounds were closed with conventional Vicryl sutures. We conducted a retrospective, multivariate analysis to determine independent risk factors for the cervical wound infection. Results: The cervical wound infection rate was 14.9% (17/112) in the Triclosan group and 14.7% (19/129) in the control group, and these rates were not significantly different. Tumour stage and delayed intra-oral flap healing were independent risk factors for cervical wound infection. Conclusions: In this preliminary study, Triclosan-coated Vicryl sutures did not reduce the infection rate of cervical wounds after head or neck cancer surgery. The effectiveness of this suture material in head and neck cancer surgery should be considered with caution. © 2010 Elsevier B.V. All rights reserved.
Original languageEnglish
Pages (from-to)300-304
Number of pages5
JournalEuropean Journal of Surgical Oncology
Volume37
Issue number4
DOIs
Publication statusPublished - 2011
Externally publishedYes

Fingerprint

Triclosan
Wound Infection
Head and Neck Neoplasms
Sutures
Polyglactin 910
Surgical Wound Infection
Control Groups
Hospital Costs
Length of Stay
Multivariate Analysis
Wounds and Injuries
Infection
Surgical Wound
Neoplasms

Keywords

  • Head and neck cancer reconstruction
  • Triclosan-coated sutures
  • Wound infection
  • suture material
  • triclosan
  • adult
  • antibacterial activity
  • article
  • cancer staging
  • controlled study
  • female
  • head and neck cancer
  • head and neck surgery
  • human
  • major clinical study
  • male
  • priority journal
  • prospective study
  • risk factor
  • skin flap
  • surgical infection
  • surgical wound
  • suture
  • uterine cervicitis
  • Adult
  • Aged
  • Anti-Bacterial Agents
  • Anti-Infective Agents, Local
  • Female
  • Head and Neck Neoplasms
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Patient Selection
  • Polyglactin 910
  • Prospective Studies
  • Reconstructive Surgical Procedures
  • Retrospective Studies
  • Risk Factors
  • Surgical Flaps
  • Surgical Wound Infection
  • Sutures
  • Treatment Failure
  • Triclosan
  • Wound Healing

Cite this

Do antibacterial-coated sutures reduce wound infection in head and neck cancer reconstruction? / Chen, Shih-Yi; Chen, Tim-Mo; Dai, Niann-Tzyy; Fu, Ju-Peng; Chang, Shun-Cheng; Deng, Shou-Cheng; Chen, Shyi-Gen.

In: European Journal of Surgical Oncology, Vol. 37, No. 4, 2011, p. 300-304.

Research output: Contribution to journalArticle

Chen, Shih-Yi ; Chen, Tim-Mo ; Dai, Niann-Tzyy ; Fu, Ju-Peng ; Chang, Shun-Cheng ; Deng, Shou-Cheng ; Chen, Shyi-Gen. / Do antibacterial-coated sutures reduce wound infection in head and neck cancer reconstruction?. In: European Journal of Surgical Oncology. 2011 ; Vol. 37, No. 4. pp. 300-304.
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title = "Do antibacterial-coated sutures reduce wound infection in head and neck cancer reconstruction?",
abstract = "Background: Surgical wound infection is a common complication, which increases the hospital stay and costs after surgery for head and neck cancer. In this study, we evaluated the effect of Triclosan-coated sutures on surgical wounds and analyzed the risk factors for wound infections in head and neck cancer surgery. Patients and Methods: From January 2007 to December 2009, 253 consecutive patients underwent wide excision of a head or neck cancer and reconstructive procedures. All patient data were collected prospectively. Of these, 241 patients were included in this study, divided into two groups. The Triclosan group contained 112 patients, whose surgical wounds were closed with Triclosan-coated sutures (Vicryl Plus). The control group included the remaining 129 patients, whose surgical wounds were closed with conventional Vicryl sutures. We conducted a retrospective, multivariate analysis to determine independent risk factors for the cervical wound infection. Results: The cervical wound infection rate was 14.9{\%} (17/112) in the Triclosan group and 14.7{\%} (19/129) in the control group, and these rates were not significantly different. Tumour stage and delayed intra-oral flap healing were independent risk factors for cervical wound infection. Conclusions: In this preliminary study, Triclosan-coated Vicryl sutures did not reduce the infection rate of cervical wounds after head or neck cancer surgery. The effectiveness of this suture material in head and neck cancer surgery should be considered with caution. {\circledC} 2010 Elsevier B.V. All rights reserved.",
keywords = "Head and neck cancer reconstruction, Triclosan-coated sutures, Wound infection, suture material, triclosan, adult, antibacterial activity, article, cancer staging, controlled study, female, head and neck cancer, head and neck surgery, human, major clinical study, male, priority journal, prospective study, risk factor, skin flap, surgical infection, surgical wound, suture, uterine cervicitis, Adult, Aged, Anti-Bacterial Agents, Anti-Infective Agents, Local, Female, Head and Neck Neoplasms, Humans, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Patient Selection, Polyglactin 910, Prospective Studies, Reconstructive Surgical Procedures, Retrospective Studies, Risk Factors, Surgical Flaps, Surgical Wound Infection, Sutures, Treatment Failure, Triclosan, Wound Healing",
author = "Shih-Yi Chen and Tim-Mo Chen and Niann-Tzyy Dai and Ju-Peng Fu and Shun-Cheng Chang and Shou-Cheng Deng and Shyi-Gen Chen",
note = "被引用次數:16 Export Date: 21 March 2016 CODEN: EJSOE 通訊地址: Chen, S. G.; Department of Surgery, National Defense Medical Center, Tri-Service General Hospital, No. 325, Cheng-Gung Road, Taipei 11490, Taiwan; 電子郵件: shyigen@ms26.hinet.net 化學物質/CAS: triclosan, 3380-34-5; Anti-Bacterial Agents; Anti-Infective Agents, Local; Polyglactin 910, 34346-01-5; Triclosan, 3380-34-5 商標: vicryl plus 參考文獻: Nuara, M.J., Sauder, C.L., Alam, D.S., Prospective analysis of outcomes and complications of 300 consecutive microvascular reconstructions (2009) Arch Facial Plast Surg, 11, pp. 235-239; Sanabria, A., Carvalho, A.L., Melo, R.L., Magrin, J., Ikeda, M.K., Vartanian, J.G., Kowalski, L.P., Predictive factors for complications in elderly patients who underwent head and neck oncologic surgery (2008) Head and Neck, 30 (2), pp. 170-177. , DOI 10.1002/hed.20671; Lotfi, C.J., Cavalcanti, R.D.C., Silva, A.M.C.E., Dias De Oliveira Latorre, M.D.R., De Cassia Braga Ribeiro, K., Carvalho, A.L., Kowalski, L.P., Risk factors for surgical-site infections in head and neck cancer surgery (2008) Otolaryngology - Head and Neck Surgery, 138 (1), pp. 74-80. , DOI 10.1016/j.otohns.2007.09.018, PII S019459980701772X; Cohn, A.B., Lang, P.O., Agarwal, J.P., Free-flap reconstruction in the doubly irradiated patient population (2008) Plast Reconstr Surg, 122, pp. 125-132; Ogihara, H., Takeuchi, K., Majima, Y., Risk factors of postoperative infection in head and neck surgery (2009) Auris Nasus Larynx, 36, pp. 457-460; Robbins, K.T., Favrot, S., Hanna, D., Cole, R., Risk of wound infection in patients with head and neck cancer (1990) Head and Neck, 12 (2), pp. 143-148; Johnson, J.T., Myers, E.N., Sigler, B.A., Antimicrobial prophylaxis for contaminated head and neck surgery (1984) Laryngoscope, 94 (1), pp. 46-51; Marco, F., Vallez, R., Gonzalez, P., Ortega, L., De La Lama, J., Lopez-Duran, L., Study of the efficacy of Coated Vicryl Plus{\circledR} antibacterial suture in an animal model of orthopedic surgery (2007) Surgical Infections, 8 (3), pp. 359-365. , DOI 10.1089/sur.2006.013; Edmiston, C.E., Seabrook, G.R., Goheen, M.P., Krepel, C.J., Johnson, C.P., Lewis, B.D., Brown, K.R., Towne, J.B., Bacterial Adherence to Surgical Sutures: Can Antibacterial-Coated Sutures Reduce the Risk of Microbial Contamination? (2006) Journal of the American College of Surgeons, 203 (4), pp. 481-489. , DOI 10.1016/j.jamcollsurg.2006.06.026, PII S1072751506010805; Rothenburger, S., Spangler, D., Bhende, S., Burkley, D., In vitro antimicrobial evaluation of coated VICRYL Plus antibacterial suture (coated polyglactin 910 with triclosan) using zone of inhibition assays (2002) Surg Infect (Larchmt), 3 (SUPPL. 1), pp. 79-S87; Justinger, C., Moussavian, M.R., Schlueter, C., Kopp, B., Kollmar, O., Schilling, M.K., Antibacterial [corrected] coating of abdominal closure sutures and wound infection (2009) Surgery, 145, pp. 330-334; Rozzelle, C.J., Leonardo, J., Li, V., Antimicrobial suture wound closure for cerebrospinal fluid shunt surgery: A prospective, double-blinded, randomized controlled trial (2008) J Neurosurg Pediatr, 2, pp. 111-117; Fleck, T., Moidl, R., Blacky, A., Fleck, M., Wolner, E., Grabenwoger, M., Wisser, W., Triclosan-Coated Sutures for the Reduction of Sternal Wound Infections: Economic Considerations (2007) Annals of Thoracic Surgery, 84 (1), pp. 232-236. , DOI 10.1016/j.athoracsur.2007.03.045, PII S0003497507006534; Coskun, H., Erisen, L., Basut, O., Factors affecting wound infection rates in head and neck surgery (2000) Otolaryngol Head Neck Surg, 123, pp. 328-333; Penel, N., Lefebvre, D., Fournier, C., Sarini, J., Kara, A., Lefebvre, J.-L., Risk factors for wound infection in head and neck cancer surgery: A prospective study (2001) Head and Neck, 23 (6), pp. 447-455. , DOI 10.1002/hed.1058; Jones, R.D., Jampani, H.B., Newman, J.L., Lee, A.S., Triclosan: A review of effectiveness and safety in health care settings (2000) American Journal of Infection Control, 28 (2), pp. 184-196; Slater-Radosti, C., Van Aller, G., Greenwood, R., Nicholas, R., Kellerb, P.M., DeWolf Jr., W.E., Fan, F., Jaworskia, D.D., Biochemical and genetic characterization of the action of triclosan on Staphylococcus aureus (2001) Journal of Antimicrobial Chemotherapy, 48 (1), pp. 1-6; McMurry, L.M., Oethinger, M., Levy, S.B., Triclosan targets lipid synthesis (1998) Nature, 394, pp. 531-532; Ming, X., Nichols, M., Rothenburger, S., In vivo antibacterial efficacy of MONOCRYL plus antibacterial suture (Poliglecaprone 25 with triclosan) (2007) Surg Infect (Larchmt), 8, pp. 209-214; Deliaert, A.E., Van Den Kerckhove, E., Tuinder, S., The effect of triclosan-coated sutures in wound healing. A double blind randomised prospective pilot study (2009) J Plast Reconstr Aesthet Surg, 62, pp. 771-773; Mingmalairak, C., Ungbhakorn, P., Paocharoen, V., Efficacy of antimicrobial coating suture coated polyglactin 910 with Tricosan (Vicryl plus) compared with polyglactin 910 (Vicryl) in reduced surgical site infection of appendicitis, double blind randomized control trial, preliminary safety report (2009) J Med Assoc Thai, 92, pp. 770-775; Ford, H.R., Jones, P., Gaines, B., Reblock, K., Simpkins, D.L., Intraoperative handling and wound healing: Controlled clinical trial comparing coated Vicryl{\circledR} plus antibacterial suture (coated polyglactin 910 suture with triclosan) with coated Vicryl{\circledR} suture (coated polyglactin 910 suture) (2005) Surgical Infections, 6 (3), pp. 313-321. , DOI 10.1089/sur.2005.6.313",
year = "2011",
doi = "10.1016/j.ejso.2011.01.015",
language = "English",
volume = "37",
pages = "300--304",
journal = "European Journal of Surgical Oncology",
issn = "0748-7983",
publisher = "W.B. Saunders Ltd",
number = "4",

}

TY - JOUR

T1 - Do antibacterial-coated sutures reduce wound infection in head and neck cancer reconstruction?

AU - Chen, Shih-Yi

AU - Chen, Tim-Mo

AU - Dai, Niann-Tzyy

AU - Fu, Ju-Peng

AU - Chang, Shun-Cheng

AU - Deng, Shou-Cheng

AU - Chen, Shyi-Gen

N1 - 被引用次數:16 Export Date: 21 March 2016 CODEN: EJSOE 通訊地址: Chen, S. G.; Department of Surgery, National Defense Medical Center, Tri-Service General Hospital, No. 325, Cheng-Gung Road, Taipei 11490, Taiwan; 電子郵件: shyigen@ms26.hinet.net 化學物質/CAS: triclosan, 3380-34-5; Anti-Bacterial Agents; Anti-Infective Agents, Local; Polyglactin 910, 34346-01-5; Triclosan, 3380-34-5 商標: vicryl plus 參考文獻: Nuara, M.J., Sauder, C.L., Alam, D.S., Prospective analysis of outcomes and complications of 300 consecutive microvascular reconstructions (2009) Arch Facial Plast Surg, 11, pp. 235-239; Sanabria, A., Carvalho, A.L., Melo, R.L., Magrin, J., Ikeda, M.K., Vartanian, J.G., Kowalski, L.P., Predictive factors for complications in elderly patients who underwent head and neck oncologic surgery (2008) Head and Neck, 30 (2), pp. 170-177. , DOI 10.1002/hed.20671; Lotfi, C.J., Cavalcanti, R.D.C., Silva, A.M.C.E., Dias De Oliveira Latorre, M.D.R., De Cassia Braga Ribeiro, K., Carvalho, A.L., Kowalski, L.P., Risk factors for surgical-site infections in head and neck cancer surgery (2008) Otolaryngology - Head and Neck Surgery, 138 (1), pp. 74-80. , DOI 10.1016/j.otohns.2007.09.018, PII S019459980701772X; Cohn, A.B., Lang, P.O., Agarwal, J.P., Free-flap reconstruction in the doubly irradiated patient population (2008) Plast Reconstr Surg, 122, pp. 125-132; Ogihara, H., Takeuchi, K., Majima, Y., Risk factors of postoperative infection in head and neck surgery (2009) Auris Nasus Larynx, 36, pp. 457-460; Robbins, K.T., Favrot, S., Hanna, D., Cole, R., Risk of wound infection in patients with head and neck cancer (1990) Head and Neck, 12 (2), pp. 143-148; Johnson, J.T., Myers, E.N., Sigler, B.A., Antimicrobial prophylaxis for contaminated head and neck surgery (1984) Laryngoscope, 94 (1), pp. 46-51; Marco, F., Vallez, R., Gonzalez, P., Ortega, L., De La Lama, J., Lopez-Duran, L., Study of the efficacy of Coated Vicryl Plus® antibacterial suture in an animal model of orthopedic surgery (2007) Surgical Infections, 8 (3), pp. 359-365. , DOI 10.1089/sur.2006.013; Edmiston, C.E., Seabrook, G.R., Goheen, M.P., Krepel, C.J., Johnson, C.P., Lewis, B.D., Brown, K.R., Towne, J.B., Bacterial Adherence to Surgical Sutures: Can Antibacterial-Coated Sutures Reduce the Risk of Microbial Contamination? (2006) Journal of the American College of Surgeons, 203 (4), pp. 481-489. , DOI 10.1016/j.jamcollsurg.2006.06.026, PII S1072751506010805; Rothenburger, S., Spangler, D., Bhende, S., Burkley, D., In vitro antimicrobial evaluation of coated VICRYL Plus antibacterial suture (coated polyglactin 910 with triclosan) using zone of inhibition assays (2002) Surg Infect (Larchmt), 3 (SUPPL. 1), pp. 79-S87; Justinger, C., Moussavian, M.R., Schlueter, C., Kopp, B., Kollmar, O., Schilling, M.K., Antibacterial [corrected] coating of abdominal closure sutures and wound infection (2009) Surgery, 145, pp. 330-334; Rozzelle, C.J., Leonardo, J., Li, V., Antimicrobial suture wound closure for cerebrospinal fluid shunt surgery: A prospective, double-blinded, randomized controlled trial (2008) J Neurosurg Pediatr, 2, pp. 111-117; Fleck, T., Moidl, R., Blacky, A., Fleck, M., Wolner, E., Grabenwoger, M., Wisser, W., Triclosan-Coated Sutures for the Reduction of Sternal Wound Infections: Economic Considerations (2007) Annals of Thoracic Surgery, 84 (1), pp. 232-236. , DOI 10.1016/j.athoracsur.2007.03.045, PII S0003497507006534; Coskun, H., Erisen, L., Basut, O., Factors affecting wound infection rates in head and neck surgery (2000) Otolaryngol Head Neck Surg, 123, pp. 328-333; Penel, N., Lefebvre, D., Fournier, C., Sarini, J., Kara, A., Lefebvre, J.-L., Risk factors for wound infection in head and neck cancer surgery: A prospective study (2001) Head and Neck, 23 (6), pp. 447-455. , DOI 10.1002/hed.1058; Jones, R.D., Jampani, H.B., Newman, J.L., Lee, A.S., Triclosan: A review of effectiveness and safety in health care settings (2000) American Journal of Infection Control, 28 (2), pp. 184-196; Slater-Radosti, C., Van Aller, G., Greenwood, R., Nicholas, R., Kellerb, P.M., DeWolf Jr., W.E., Fan, F., Jaworskia, D.D., Biochemical and genetic characterization of the action of triclosan on Staphylococcus aureus (2001) Journal of Antimicrobial Chemotherapy, 48 (1), pp. 1-6; McMurry, L.M., Oethinger, M., Levy, S.B., Triclosan targets lipid synthesis (1998) Nature, 394, pp. 531-532; Ming, X., Nichols, M., Rothenburger, S., In vivo antibacterial efficacy of MONOCRYL plus antibacterial suture (Poliglecaprone 25 with triclosan) (2007) Surg Infect (Larchmt), 8, pp. 209-214; Deliaert, A.E., Van Den Kerckhove, E., Tuinder, S., The effect of triclosan-coated sutures in wound healing. A double blind randomised prospective pilot study (2009) J Plast Reconstr Aesthet Surg, 62, pp. 771-773; Mingmalairak, C., Ungbhakorn, P., Paocharoen, V., Efficacy of antimicrobial coating suture coated polyglactin 910 with Tricosan (Vicryl plus) compared with polyglactin 910 (Vicryl) in reduced surgical site infection of appendicitis, double blind randomized control trial, preliminary safety report (2009) J Med Assoc Thai, 92, pp. 770-775; Ford, H.R., Jones, P., Gaines, B., Reblock, K., Simpkins, D.L., Intraoperative handling and wound healing: Controlled clinical trial comparing coated Vicryl® plus antibacterial suture (coated polyglactin 910 suture with triclosan) with coated Vicryl® suture (coated polyglactin 910 suture) (2005) Surgical Infections, 6 (3), pp. 313-321. , DOI 10.1089/sur.2005.6.313

PY - 2011

Y1 - 2011

N2 - Background: Surgical wound infection is a common complication, which increases the hospital stay and costs after surgery for head and neck cancer. In this study, we evaluated the effect of Triclosan-coated sutures on surgical wounds and analyzed the risk factors for wound infections in head and neck cancer surgery. Patients and Methods: From January 2007 to December 2009, 253 consecutive patients underwent wide excision of a head or neck cancer and reconstructive procedures. All patient data were collected prospectively. Of these, 241 patients were included in this study, divided into two groups. The Triclosan group contained 112 patients, whose surgical wounds were closed with Triclosan-coated sutures (Vicryl Plus). The control group included the remaining 129 patients, whose surgical wounds were closed with conventional Vicryl sutures. We conducted a retrospective, multivariate analysis to determine independent risk factors for the cervical wound infection. Results: The cervical wound infection rate was 14.9% (17/112) in the Triclosan group and 14.7% (19/129) in the control group, and these rates were not significantly different. Tumour stage and delayed intra-oral flap healing were independent risk factors for cervical wound infection. Conclusions: In this preliminary study, Triclosan-coated Vicryl sutures did not reduce the infection rate of cervical wounds after head or neck cancer surgery. The effectiveness of this suture material in head and neck cancer surgery should be considered with caution. © 2010 Elsevier B.V. All rights reserved.

AB - Background: Surgical wound infection is a common complication, which increases the hospital stay and costs after surgery for head and neck cancer. In this study, we evaluated the effect of Triclosan-coated sutures on surgical wounds and analyzed the risk factors for wound infections in head and neck cancer surgery. Patients and Methods: From January 2007 to December 2009, 253 consecutive patients underwent wide excision of a head or neck cancer and reconstructive procedures. All patient data were collected prospectively. Of these, 241 patients were included in this study, divided into two groups. The Triclosan group contained 112 patients, whose surgical wounds were closed with Triclosan-coated sutures (Vicryl Plus). The control group included the remaining 129 patients, whose surgical wounds were closed with conventional Vicryl sutures. We conducted a retrospective, multivariate analysis to determine independent risk factors for the cervical wound infection. Results: The cervical wound infection rate was 14.9% (17/112) in the Triclosan group and 14.7% (19/129) in the control group, and these rates were not significantly different. Tumour stage and delayed intra-oral flap healing were independent risk factors for cervical wound infection. Conclusions: In this preliminary study, Triclosan-coated Vicryl sutures did not reduce the infection rate of cervical wounds after head or neck cancer surgery. The effectiveness of this suture material in head and neck cancer surgery should be considered with caution. © 2010 Elsevier B.V. All rights reserved.

KW - Head and neck cancer reconstruction

KW - Triclosan-coated sutures

KW - Wound infection

KW - suture material

KW - triclosan

KW - adult

KW - antibacterial activity

KW - article

KW - cancer staging

KW - controlled study

KW - female

KW - head and neck cancer

KW - head and neck surgery

KW - human

KW - major clinical study

KW - male

KW - priority journal

KW - prospective study

KW - risk factor

KW - skin flap

KW - surgical infection

KW - surgical wound

KW - suture

KW - uterine cervicitis

KW - Adult

KW - Aged

KW - Anti-Bacterial Agents

KW - Anti-Infective Agents, Local

KW - Female

KW - Head and Neck Neoplasms

KW - Humans

KW - Male

KW - Middle Aged

KW - Multivariate Analysis

KW - Odds Ratio

KW - Patient Selection

KW - Polyglactin 910

KW - Prospective Studies

KW - Reconstructive Surgical Procedures

KW - Retrospective Studies

KW - Risk Factors

KW - Surgical Flaps

KW - Surgical Wound Infection

KW - Sutures

KW - Treatment Failure

KW - Triclosan

KW - Wound Healing

U2 - 10.1016/j.ejso.2011.01.015

DO - 10.1016/j.ejso.2011.01.015

M3 - Article

VL - 37

SP - 300

EP - 304

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

SN - 0748-7983

IS - 4

ER -