Систематический обзор и метаанализ применения шовного материала с покрытием из триклозана для предотвращения инфекций области хирургического вмешательства (ИОХВ)

Автор: Wang Z.X., Jiang C.P., Cao Y., Ding Y.T.

Журнал: Кафедра травматологии и ортопедии @jkto

Рубрика: Обзор литературы

Статья в выпуске: 2 (6), 2013 года.

Бесплатный доступ

История вопроса. Инфекции области хирургического вмешательства (ИОХВ) вызывают увеличение заболеваемости и смертности пациентов хирургического профиля и представляют собой серьезное экономическое бремя для системы здравоохранения. Проведенные эксперименты показали, что шовный материал с покрытием из триклозана (ШМТ) способствует предотвращению ИОХВ, однако результаты отдельных рандомизированных контролируемых исследований (РКИ) являются неубедительными. Для оценки эффективности ШМТ при профилактике ИОХВ был проведен метаанализ опубликованных РКИ. Методы. До июня 2012 г. в базах данных медицинских и биологических публикаций PubMed, Embase, MEDLINE, Web of Science®, Cochrane Central Register of Controlled Trials, а также в электронных архивах клинических исследований проводился систематический поиск публикаций РКИ, в которых сравнивалось влияние ШМТ и традиционного шовного материала без покрытия на развитие ИОХВ. Первичной конечной точкой исследования была частота возникновения ИОХВ. Для расчета обобщенных относительных рисков с 95% доверительным интервалом (ДИ) использовалось программное обеспечение RevMan 5.1.6. Результаты. В анализ были включены 17 РКИ, в которых участвовало 3720 пациентов. При сравнении исследований неоднородности статистической достоверности не отмечалось. Использование ШМТ имело существенное преимущество и вызывало снижение частоты возникновения ИОХВ на 30% (относительный риск 0,70, 95% ДИ от 0,57 до 0,85; p Background. Surgical site infections (SSIs) cause an increase in morbidity and mortality in surgical patients and represent a significant economic burden on the healthcare system. The experiments showed that the suture coated with triclosan (CMT) will help prevent wound infection, but the results of individual randomized controlled trials (RCTs) are inconclusive. To evaluate the efficiency of CMT in the prevention of SSIs was conducted a meta-analysis of published RCTs. Methods. Prior to June 2012 in the databases of medical and biological publications PubMed, Embase, MEDLINE, Web of Science ®, Cochrane Central Register of Controlled Trials, as well as in the electronic archives of clinical research in systematic search for publications of randomized trials that compared the effects of CMT and traditional suture without covering the development of SSIs. The primary endpoint was the incidence of SSIs. To calculate the distributions of relative risks with 95% confidence intervals (CI) software was used RevMan 5.1.6. Results. In the analysis included 17 studies, involving 3720 patients. In comparison studies inhomogeneity statistical significance was observed. The use of CMT had a significant advantage and caused a decrease in the incidence of wound infection by 30% (relative risk 0.70, 95% CI 0.57 to 0,85; p

Еще

Хирургические инфекции, шовный материал, триклоза

Короткий адрес: https://sciup.org/142211348

IDR: 142211348

Список литературы Систематический обзор и метаанализ применения шовного материала с покрытием из триклозана для предотвращения инфекций области хирургического вмешательства (ИОХВ)

  • Barie P.S. Surgical site infections: epidemiology and prevention//Surg. Infect. (Larchmt). 2002. Vol. 3 (Suppl. 1). S. 9-21.
  • Leaper D.J., van Goor H., Reilly J., Petrosillo N., Geiss H.K., Torres A.J. et al. Surgical site infection -a European perspective of incidence and economic burden//Int. Wound J. 2004. Vol.1. P. 247-273.
  • Hawn M.,. Vick C.C., Richman J., Holman W., Deierhoi R.J., Graham L.A. et al. Surgical site infection prevention: time to move beyond the surgical care improvement program//Ann. Surg. 2011. Vol. 254. P. 494-499.
  • Patkar A.D., Magee G., Vaughn B., Edmiston C.E., Vardireddy N. The economic burden of surgical site infection using therapeutic antibiotic utilization measure -comparison of two time periods//Value in Health. 2010. Vol. 13. A432.
  • Alexander J.W., Solomkin J.S., Edwards M.J. Updated recommendations for control of surgical site infections//Ann. Surg. 2011. Vol. 253. P. 1082-1093.
  • Odom-Forren J. Preventing surgical site infections//Nursing. 2006. Vol. 36. P. 58-63.
  • Alexander J.W., Kaplan J.Z., Altemeier W.A. Role of suture materials in the development of wound infection.//Ann. Surg. 1967. Vol. 165. P. 192-199.
  • Katz S., Izhar M., Mirelman D. Bacterial adherence to surgical sutures. A possible factor in suture induced infection.//Ann. Surg. 1981. Vol. 194. P. 35-41.
  • Storch M.L., Rothenburger S.J., Jacinto G. Experimental efficacy study of coated VICRYL Plus antibacterial suture in guinea pigs challenged with Staphylococcus aureus//Surg. Infect. (Larchmt). 2004. Vol. 5. P. 281-288.
  • Edmiston C.E., Seabrook G.R., Goheen M.P., Krepel C.J., Johnson C.P., Lewis B.D. et al. Bacterial adherence to surgical sutures: can antibacterial-coated sutures reduce the risk of microbial contamination?//J. Am. Coll. Surg. 2006. Vol. 203. P. 481-489.
  • 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. (Larchmt). 2002. Vol. 3 (Suppl.1). S. 79-87.
  • Ming X., Rothenburger S., Yang D. In vitro antibacterial efficacy of MONO CRYL Plus antibacterial suture (poliglecaprone 25 with triclosan)//Surg. Infect. (Larchmt). 2007. Vol. 8. P. 201-208.
  • Bojar W., Kazmierska K., Szalwinski M., Zareba T. Triclosancoated sutures in oral surgery//Advances in Clinical and Experimental Medicine. 2009. Vol. 18. P. 401-405.
  • 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//Surg. Infect. (Larchmt). 2007. Vol. 8. P. 359-365.
  • Ming X., Nichols M., Rothenburger S. In vivo antibacterial efficacy of MONO CRYL Plus antibacterial suture (poliglecaprone 25 with triclosan)//Surg. Infect. (Larchmt). 2007. Vol. 8. P. 209-214.
  • Ming X., Rothenburger S., Nichols M.M. In vivo and in vitro antibacterial efficacy of PDS Plus (polidioxanone with triclosan) suture//Surg. Infect. (Larchmt). 2008. Vol. 9. P. 451-457.
  • Storch M., Perry L.C., Davidson J.M., Ward J.J. A28-day study of the effect of coated VICRYL* Plus antibacterial suture (coated polyglactin 910 suture with triclosan) on wound healing in guinea pig linear incisional skin wounds//Surg. Infect. (Larchmt). 2002. Vol. 3 (Suppl. 1). S. 89-98.
  • Storch M., Scalzo H., Van Lue S., Jacinto G. Physical and functional comparison of coated VICRYL* Plus antibacterial suture (coated polyglactin 910 suture with triclosan) with coated VICRYL* suture (coated polyglactin 910 suture)//Surg. Infect. (Larchmt). 2002. Vol. 3 (Suppl. 1). S. 65-77.
  • Fleck T., Moidl R., Blacky A., Fleck M., Wolner E., Grabenwoger M. et al. Triclosan-coated sutures for the reduction of sternal wound infections: economic considerations//Ann. Thorac. Surg. 2007. Vol. 84. P. 232-236.
  • Justinger C., Schuld J., Sperling J., Kollmar O., Richter S., Schilling M.K. Triclosan-coated sutures reduce wound infections after hepatobiliary surgery -a prospective non-randomized clinical pathway driven study//Langenbecks Arch. Surg. 2011. Vol.396. P. 845-850.
  • Rozzelle C.J., Leonardo J., Li V. Antimicrobial suture wound closure for cerebrospinal fluid shunt surgery: a prospective, double-blinded, randomized controlled trial//J. Neurosurg. Pediatr. 2008. Vol. 2. P. 111 -117.
  • Galal I., El-Hindawy K. Impact of using triclosan-antibacterial sutures on incidence of surgical site infection//Am. J. Surg. 2011. Vol. 202. P. 133-138.
  • Rasic Z., Schwarz D., Adam V.N., Sever M., Lojo N., Rasic D. et al. Efficacy of antimicrobial triclosan-coated polyglactin(Vicryl* Plus) suture for closure of the abdominal wall after colorectal surgery//Coll. Antropol. 2011. Vol. 35. P. 439-443.
  • Baracs J., Huszaґr O., Sajjadi S.G., Horvaґth O.P. Surgical site infections after abdominal closure in colorectal surgery using triclosan-coated absorbable suture (PDS Plus) vs. uncoated sutures (PDS II): a randomized multicenter study//Surg. Infect. (Larchmt). 2011. Vol. 12. P. 483-489.
  • DeFazio A., Datta M.S., Nezhat C. Does the use of Vicryl Plus antibacterial suture decrease the incidence of umbilical infection when compared to Vicryl suture?//Fertil. Steril. 2005. Vol. 84 (Suppl. 1). S. 161.
  • Mingmalairak C., Ungbhakorn P., Paocharoen V. Efficacy of antimicrobial coating suture coated polyglactin 910 with triclosan (Vicryl Plus) compared with polyglactin 910 (Vicryl) in reduced surgical site infection of appendicitis, double blind randomized control trial, preliminary safety report//J. Med. Assoc. Thai. 2009. Vol. 92. P. 770-775.
  • Zhang Z.T., Zhang H.W., Fang X.D., Wang L.M., Li X.X., Li Y.F. et al. Cosmetic outcome and surgical site infection rates of antibacterial absorbable (polyglactin 910) suture compared to Chinese silk suture in breast cancer surgery: a randomized pilot research//Chin. Med. J. (Engl.). 2011. Vol. 124. P. 719-724.
  • Seim B.E., Tшnnessen T., Woldbaek P.R. Triclosan-coated sutures do not reduce leg wound infections after coronary artery bypass grafting//Interact. Cardiovasc. Thorac. Surg. 2012. Vol. 15. P. 411-415.
  • Turtiainen J., Saimanen E.I., MaЁkinen K.T., NykaЁnen A.I., Venermo M.A., Uurto I.T. et al. Effect of triclosan-coated sutures on the incidence of surgical wound infection after lower limb revascularization surgery: a randomized controlled trial//World J. Surg. 2012. Vol. 36. P. 2528-2534.
  • Chang W.K., Srinivasa S., Morton R., Hill A.G. Triclosanimpregnated sutures to decrease surgical site infections: systematic review and meta-analysis of randomized trials//Ann. Surg. 2012. Vol.255. P. 854-859.
  • Zhuang C.P., Cai G.Y., Wang Y.Q. Comparison of two absorbable sutures in abdominal wall incision//Journal of Clinical Rehabilitative Tissue Engineering Research. 2009. Vol. 13. P. 4045-4048.
  • Singh H., Emmert M.Y., Sakaguchi H., Neng Lee C., Kofidis T. Antibacterial suture reduces surgical site infections in coronary artery bypass grafting//Heart Surgery Forum. 2010. Vol. 13. S. 85.
  • Khachatryan N., Dibirov M., Omelyanovsky V., Chupalov M., Gasanova G. Prevention of postoperative infections in abdominal surgery using reabsorbable suture with antibacterial activity (Vicryl Plus) versus reabsorbable standard sutures//Surg. Infect. (Larchmt). 2011. Vol. 12. P. 13-14.
  • Mattavelli I., Nespoli L., Alfieri S., Cantore F., Sebastian-Douglas S., Cobianchi L. et al. Triclosan-coated suture to reduce surgical site infection after colorectal surgery//Surg. Infect. (Larchmt). 2011. Vol. 12. P. 14-15.
  • Williams N., Sweetland H., Goyal S., Ivins N., Leaper D.J. Randomized trial of antimicrobial-coated sutures to prevent surgical site infection after breast cancer surgery//Surg. Infect. (Larchmt). 2011. Vol. 12. P. 469-474.
  • Isik I., Selimen D., Senay S., Alhan C. Efficiency of antibacterial suture material in cardiac surgery: a double-blind randomized prospective study//The Heart Surgery Forum. 2012. Vol. 15. P. 40-45.
  • Moher D., Liberati A., Tetzlaff J., Altman D.G. The PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement//Open. Med. 2009. Vol.3. P. 123-130.
  • ClinicalTrials.gov. http://www.clinicaltrial.gov [accessed 9 May 2012].World Health Organization. International Clinical Trials Registry Platform Search Portal.
  • http://apps.who.int/trialsearch/Default.aspx [accessed 9 May 2012].
  • The Cochrane Collaboration. Cochrane Handbook for Systematic Reviews of Interventions. http://www.cochranehandbook. org [accessed 9 May 2012].
  • Mangram A.J., Horan T.C., Pearson M.L., Silver L.C., Jarvis W.R. Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee//Am.J. Infect. Control. 1999. Vol. 27. P. 97-132.
  • The Cochrane Collaboration. Review Manager. Version 5.1.6. The Nordic Cochrane Centre, The Cochrane Collaboration: Copenhagen, 2011.
  • Lau J., Ioannidis J.P., Schmid C.H. Quantitative synthesis in systematic reviews//Ann. Intern. Med. 1997. Vol. 127. P. 820-826.
  • Mantel N., Haenszel W. Statistical aspects of the analysis of data from retrospective studies of disease//J. Natl. Cancer Inst. 1959. Vol. 22. P. 719-748.
  • DerSimonian R., Laird N. Meta-analysis in clinical trials//Control Clin. Trials. 1986. Vol. 7. P. 177-188.
  • Higgins J.P., Thompson S.G. Quantifying heterogeneity in a meta-analysis//Stat. Med. 2002. Vol. 21. P. 1539-1558.
  • Deliaert A.E., Van den Kerckhove E., Tuinder S., Fieuws S., Sawor J.H., Meesters-Caberg M.A. et al. The effect of triclosancoated sutures in wound healing. A double blind randomised prospective pilot study//J. Plast. Reconstr. Aesthet. Surg. 2009. Vol. 62. P. 771-773.
  • 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)//Surg. Infect. (Larchmt). 2005. Vol. 6. P. 313-321.
  • Masini B.D., Stinner D.J., Waterman S.M., Wenke J.C. Bacterial adherence to suture materials//J. Surg. Educ. 2011. Vol. 68. P. 101-104.
  • Gristina A.G., Price J.L., Hobgood C.D., Webb L.X., Costerton J.W. Bacterial colonization of percutaneous sutures//Surgery. 1985. Vol. 98. P. 12-19.
  • Goґmez-Alonso A., Garcґıa-Criado F.J., Parren˜o-Manchado F.C., Garcґıa-Saґnchez J.E., Garcґıa-Saґnchez E., Parren˜oManchado A. et al. Study of the efficacy of coated VICRYL Plus antibacterial suture (coated polyglactin 910 suture with triclosan) in two animal models of general surgery//J. Infect. 2007. Vol. 54. P. 82-88.
  • Wolcott R., Cutting K.F., Dowd S.E. Surgical site infections: biofilms, dehiscence and delayed healing//Wounds UK. 2008. Vol. 4. P. 108-113.
  • Glassman J.A., Fowler E.F., Novak M.V. An experimental study of sulfonamide impregnated sutures//Surg. Obstet. Gynecol. 1944. Vol. 78. P. 359-363.
  • Darouiche R.O., Meade R., Mansouri M., Raad II. In vivo efficacy of antimicrobial-coated fabric from prosthetic heart valve sewing rings//J. Heart Valve Dis. 1998. Vol. 7. P. 639-646.
  • Blaker J.J., Nazhat S.N., Boccaccini A.R. Development and characterisation of silver-doped bioactive glass-coated sutures for tissue engineering and wound healing applications//Biomaterials. 2004. Vol. 25. P. 1319-1329.
  • Barbolt T.A. Chemistry and safety of triclosan, and its use as an antimicrobial coating on coated VICRYL* Plus antibacterial suture (coated polyglactin 910 suture with triclosan)//Surg. Infect. (Larchmt). 2002. Vol. 3 (Suppl. 1). S. 45-53.
  • Leaper D., Assadian O., Hubner N.O., McBain A., Barbolt 57. t T., Rothenburger S. et al. Antimicrobial sutures and prevention of surgical site infection: assessment of the safety of the antiseptic triclosan//Int. Wound J. 2011. Vol. 8. P. 556-566.
  • Sacks H.S., Berrier J., Reitman D., Ancona-Berk V.A., Chalmers T.C. Meta-analyses of randomized controlled trials//N. Engl. J. Med. 1987. Vol. 316. P. 450-455.
  • Gaynes R.P., Culver D.H., Horan T.C., Edwards J.R., Richards C., Tolson J.S. Surgical site infection (SSI) rates in the United States, 1992-1998: the National Nosocomial Infections Surveillance System basic SSI risk index//Clin. Infect. Dis. 2001. Vol. 33 (Suppl. 2). S. 69-77.
  • Fry D.E. The economic costs of surgical site infection//Surg. Infect. (Larchmt). 2002. Vol. 3 (Suppl. 1). S. 37-43.
  • Edmiston C.E., Patkar A.D., Magee G., Seabrook G.R., Vaughn B. Use of an observational, nationwide inpatient discharge database to document the economic benefits associated with innovative antimicrobial technology to reduce the risk of surgical site infection (SSI)//Am. J. Infect. Control. 2010. Vol.38. P. 38.
  • Horan T.C., Gaynes R.P., Martone W.J., Jarvis W.R., Emori T.G. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections//Am. J. Infect. Control. 1992. Vol. 20. P. 271-274.
Еще
Статья обзорная