Triclosan-Coated Sutures Now Recommended by the World Health Organization

Ethicon announces that triclosan-coated sutures received a recommendation in the new Global Guidelines for the Prevention of Surgical Site Infections, the first-ever global guidelines on SSIs released by the World Health Organization (WHO). Categorized as a conditional recommendation, the use of triclosan-coated sutures is now supported by the WHO based on moderate-quality of evidence. According to the new WHO Guidelines, “the panel suggests the use of triclosan-coated sutures for the purpose of reducing the risk of surgical site infection (SSI), independent of the type of surgery.”

Suture selection provides an important opportunity to address a key risk factor for infection – bacterial colonization of the suture. Ethicon Plus Sutures are the only globally available sutures coated with triclosan that inhibit colonization of the suture by bacteria commonly associated with SSIs, including S. aureus, S. epidermidis, MRSA, MRSE, E. coli+, and K. pneumonia+.(1-3) To that end, Ethicon offers a comprehensive range of antibacterial sutures,  including Coated VICRYL® Plus Antibacterial (polyglactin 910); MONOCRYL® Plus Antibacterial (poliglecaprone 25); PDS® Plus Antibacterial (polydioxanone); STRATAFIX™ Spiral PDS Plus Knotless Tissue Control Device; STRATAFIX™ Spiral Monocryl Plus Knotless Tissue Control Device; and STRATAFIX™ Symmetric PDS™ Plus Knotless Tissue Control Device.

“Several independent studies have found that triclosan-coated sutures reduce the risk of SSI across many types of surgery,” said professor David Leaper of the University of Newcastle upon Tyne and the University of Huddersfield in the United Kingdom. “Taken together with other evidence-based interventions, Ethicon Plus Sutures may help reduce hospital costs associated with infections, including longer length of stay or readmission.”

Ethicon first innovated the triclosan coated suture with the introduction of Coated VICRYL® Plus Antibacterial (polyglactin 910) suture in 2003. SSIs are among the most common healthcare-associated infections (HAI) worldwide; they increase morbidity and mortality in surgical patients and represent an economic burden to healthcare systems.(4) In fact, SSIs are the leading infection in the general patient population in countries with limited resources, affecting up to two-thirds of operated patients and with a frequency up to nine times higher than in developed countries.(5)

“Ethicon has more than 60 years of experience in surgical sutures, and the new guidelines from WHO supports our Ethicon Plus Sutures portfolio and further reinforces our decade-long commitment to helping surgeons and their institutions address the overwhelming burden of healthcare associated infections,” said Liza Ovington, franchise medical director for Ethicon. “Ethicon is committed to shaping the future of surgery by helping address the world’s most pressing healthcare issues to improve and save more lives.”

Ethicon Plus Sutures have been shown in vitro to inhibit bacterial colonization of the suture for seven days or more.(3) By inhibiting bacterial colonization of the suture by pathogens commonly associated with SSIs, a key risk factor for infection is addressed. Numerous peer reviewed, randomized controlled trials, as well as prospectively planned meta-analyses of these trials, contribute to the growing body of evidence that antibacterial sutures are an important tool in the fight against surgical site infections.

References:

1. Ming X, Rothenburger S, Nichols MM. In vivo and invitro antibacterial efficacy of PDS Plus (polidioxanone with triclosan) suture. Surg Infect. 2008;9(4):451-457.
2. Ming X, Rothenburger S, Yang D. In vitro antibacterial efficacy of Monocryl Plus Antibacterial Suture (poligelcaprone 25 with triclosan). Surg Infect. 2007;8(2):201-207.
3. 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. Surg Infect. 2002;3(suppl):79-87.
4. Wang ZX, Jiang CP, Cao Y, Ding YT. Systematic review and meta-analysis of triclosan-coated sutures for the prevention of surgical-site infection. Br J Surg. 2013;100(4):465-473.
5. Fact Sheet: Health care-associated infections. Accessed September 22, 2016: http://www.who.int/gpsc/country_work/gpsc_ccisc_fact_sheet_en.pdf.