Bacterial Adherence to Surgical Sutures: Can Antibacterial-Coated Sutures Reduce the Risk of Microbial Contamination? - 09/08/11
⁎, Gary R. Seabrook, MD, FACS , Michael P. Goheen, MS ‡, Candace J. Krepel, MS , Christopher P. Johnson, MD, FACS †, Brian D. Lewis, MD, FACS , Kellie R. Brown, MD, FACS , Jonathan B. Towne, MD, FACS Division of Vascular, Medical College of Wisconsin, Milwaukee, WI Correspondence address: Charles E Edmiston Jr, PhD, Division of Vascular Surgery, 9200 West Wisconsin Ave, Milwaukee, WI 53226.Résumé |
Background |
Surgical site infections are associated with severe morbidity and mortality. The role of surgical sutures in the etiology of surgical site infection has been the objective of discussion for decades. This study used a standardized in vitro microbiologic model to assess bacterial adherence and the antibacterial activity of a triclosan-coated polyglactin 910 (braided) suture against selected Gram-positive and Gram-negative clinical isolates that may infect surgical wounds.
Study Design |
Standardized cultures (2.0 log10 colony forming units/mL and 5.0 log10 colony forming units/mL of three clinical strains, Staphyllococcus aureus (methicillin-resistant S aureus [MRSA]), S epidermidis (biofilm-positive) and Escherichia coli (extended-spectrum beta-lactamase [ESBL]-producer) were inoculated to triclosan-coated and noncoated polyglactin 910 sutures to evaluate comparative adherence of bacterial isolates to the antibacterial coated and noncoated surgical sutures; to assess the impact of serum proteins (bovine serum albumin) on antibacterial activity of triclosan-coated suture; and to document the duration of antibacterial activity of the triclosan-coated material. Selected suture samples were prepared for scanning electron microscopy to demonstrate bacterial adherence.
Results |
Substantial (p < 0.01) reductions in both Gram-positive and Gram-negative bacterial adherence were observed on triclosan-coated sutures compared with noncoated material. Pretreatment of surgical sutures with 20% BSA did not diminish antibacterial activity of the triclosan-coated braided device compared with noncoated suture (p < 0.01), and antibacterial activity was documented to persist for at least 96 hours compared with controls (p < 0.01).
Conclusions |
The in vitro model demonstrated a considerable reduction (p < 0.01) in Gram-positive and Gram-negative bacterial adherence to a triclosan-coated braided suture, which was associated with decreased microbial viability (p < 0.001). Because bacterial contamination of suture material within a surgical wound may increase the virulence of a surgical site infection, treating the suture with triclosan provides an effective strategy for reducing perioperative surgical morbidity.
Le texte complet de cet article est disponible en PDF.Abbreviations and Acronyms : cfu, 3X, TSB
Plan
| Competing Interests Declared: None. This study was supported by the Surgical Microbiology Research Fund in the Department of Surgery at the Medical College of Wisconsin. |
Vol 203 - N° 4
P. 481-489 - octobre 2006 Retour au numéro
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