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Plus Antibacterial Sutures
Plus Antibacterial Sutures
ETHICON PLUS Antibacterial Sutures were developed to address the challenge of surgical site infection.
Plus Antibacterial Sutures handle like traditional sutures.1-4
New NICE Medical Technologies Guidance recommends the use of Ethicon Plus Sutures for surgeries in the NHS
Features & Benefits
Why Risk an SSI?
Surgical Site Infections (SSI)5,6
‐ 37% of hospital acquired infections in surgical patients are SSIs
‐ Patients with an SSI are twice as likely to spend time in an intensive care unit
‐ Patients with an SSI are five times more likely to be readmitted after discharge
‐ Patients with an SSI are twice as likely to die
‐ 40‐60% of surgical site infections may be preventable
SSIs are common & costly for patients and hospitals; the average cost of managing a single patient with an SSI was estimated at £3,122.7-9*
Multiple meta-analyses support the use of PLUS Antibacterial Sutures to reduce the risk of SSI by up to 28%.10-12
In the presence of a foreign body, such as suture, it takes only 100 staphylococci per gram of tissue for an SSI to develop13
Once a suture is introduced into a surgical incision, bacteria on the surface of the epidermis, disrupted while making a skin incision, migrate from the surface to the foreign body, which is the site of SSI initiation.14,15
Plus Antibacterial Sutures have been shown in vitro to inhibit bacterial colonization of the suture for 7 days or more and are effective against the most common organisms associated with SSIs: 4,16,17
Plus Sutures for Preventing Surgical Site Infection - NICE Medical Technologies Guidance
Triclosan-coated sutures are supported by evidence-based recommendations from a number of global health authorities as part of the SSI prevention bundle.18-22^
* Average cost from the UK, based on NICE Guideline (NG125) 'Surgical site infections; prevention and treatment', published date: 11 April 2019. Last updated: 19 August 2020.
** PDS™ Plus Antibacterial (polydioxanone) Suture and MONOCRYL™ Plus Antibacterial (poliglecaprone 25) Suture only.
^ CDC, WHO, ACS/SIS, NICE, and KRINKO guidelines on reducing the risk of surgical site infections are general to triclosan‐coated sutures and are not specific to any one brand. Recommendations for different types of surgery may not be consistent across authorities.
1. Barbolt TA. 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;3(suppl):S45‐S53.
2. Ford HR, Jones P, Gaines B, Reblock K, Simpkins DL. 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;6(3):313‐321.
3. Gilbert P, McBain AJ. Literature‐based evaluation of the potential risks associated with impregnation of medical devices and implants with triclosan.Surg Infect (Larchmt). 2002;3(suppl):S55‐S63.
4. 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;3(suppl):S79‐S87.
5. World Health Organization. Safe surgery saves lifes. WHO Guidelines for Safe Surgery 2009.
6. Odom‐Forren, Preventing Surgical Site Infections. Nursing 2009; 36: 58‐63.
7. Leaper DJ, van Goor H, Reilly J, et al. Surgical site infection – a European perspective of incidence and economic burden. Int Wound J. 2004;1(4):247‐273.
8. Jenks PJ, Laurent M, McQuarry S,Watkins R. Clinical and economic burden of surgical site infection (SSI) and predicted financial consequences of elimination of SSI from an English hospital. J Hosp Infect 2014; 86:24–33.
9. NICE Guideline NG125, Surgical Site Infection: Prevention and Treatment. April 2019.
10. de Jonge S, Atema J, Solomkin J and Boermeester M, Meta‐Analysis and trial sequential analysis of triclosan‐coated sutures for the prevention of surgical‐site infection. 2017; BJS 104 e118‐e133.
11. Wang ZX, Jiang CP, Cao Y, Ding YT. Systematic review and meta analysis of Triclosan‐coated sutures for prevention of surgical‐site infection. 2013; 100:465‐474.
12. Edmiston CE, Daoud FC, Leaper D. Is there an evidence‐based argument for embracing an antimicrobial (Triclosan)‐coated suture technology to reduce the risk for surgical‐site infections? A meta‐analysis. 2013; 154:89‐100.
13. Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1999;20(4):247‐278.
14. Edmiston, Jr CE, Krepel CJ, Marks RM, et al. Microbiology of explanted suture segments from infected and noninfected surgical patients. J Clin Microbiol. 2013;51:417‐421.
15. National Institute for Health and Clinical Excellence. Surgical site infection: Prevention and treatment of surgical site infection. NICE Clinical Guidelines No.74. RCOG Press. October 2008. https://www.ncbi.nlm.nih.gov/books/NBK53731/ Accessed 9th Dec 2020.
16. Ming X, Rothenburger S, Yang D. In vitro antibacterial efficacy of Monocryl Plus Antibacterial Suture (poliglecaprone 25 with triclosan). Surg Infect (Larchmt). 2007;8(2):201‐207.
17. Ming X, Rothenburger S, Nichols MM. In vivo in vitro antibacterial efficacy of PDS* Plus (polydioxanone with Triclosan) Suture. Surg Infect (Larchmt). 2008;9(4):451‐457.
18. Berrios‐Torres SI, Umscheid CA, Bratzler DW, et al. Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg. 2017;152(8):784‐791.
19. Ban KA, Minei JP, Laronga C, et al. American college of surgeons and surgical infection society: surgical site infection guidelines, 2016 update. J Am Coll Surg. 2017; 224(1):59‐74.
20. NICE Guideline Updates Team (UK). Surgical site infection: prevention and treatment. NICE website. https://www.nice.org.uk/guidance/ng125/chapter/Recommendations#closuremethods
Accessed Nov 16, 2020.
21. World Health Organization. Global guidelines for the prevention of surgical site infection.
Published November 2016. Accessed Nov 16, 2020.
22. Prevention of postoperative wound infections. Recommendation of the Committee for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute. Bundesgesundheitsbl. 2018;61(4):448‐473.
23. NICE Guideline Updates Team (UK). Surgical site infection: prevention and treatment. NICE website. https://www.nice.org.uk/guidance/ng125/chapter/Recommendations#intraoperative-phase
Accessed Apr 16, 2021.
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